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					                                                Appendix A

                                     Summary of Impact Studies
                                  Identified in the Literature Review
              Note: As discussed in the text, all identified research that described differences
              between participants and nonparticipants is included in these tables. Although some of
              these studies had weak designs or used rudimentary or, in some cases, no statistical
              analysis, they are included in the interest of completeness. The tables include informa-
              tion about both design and analysis methods. In interpreting findings from the com-
              plete body of research for a given program, greater weight was given to findings from
              studies that had the strongest design and analysis methods and that used the most
              recent data.




Economic Research Service/USDA      Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4   43
                                        Food Stamp Program




Economic Research Service/USDA   Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4   45
                                                                                         Appendix table 1—Studies that examined the impact of the Food Stamp Program on household food expenditures
46



                                                                                                                                            Measure of              Population                           Measure of
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                  1                     2
                                                                                         Study                          Data source        expenditures           (sample size)        Design            participation          Analysis method

                                                                                         Group IA: Participant vs. nonparticipant comparisons—Secondary analysis of national surveys
                                                                                         Hama and                1977-78              At-home                  FSP-eligible       Participant vs.   Participation dummy    Simultaneous food
                                                                                         Chern (1988)            NFCS elderly         Nonpurchased food        households with    nonparticipant                           expenditure/nutrient
                                                                                                                                                                                                                                                 3
                                                                                                                 supplement           included                 elderly members                                             availability equation
                                                                                                                                      Per person per week      (n=1,454)
                                                                                         Kisker and              1979-80 NFCS-LI      At-home                  FSP-eligible       Participant vs.   Participation dummy    Bivariate t-tests
                                                                                         Devaney (1988)                               Nonpurchased food        households         nonparticipant
                                                                                                                                      included                 (n~2,900)
                                                                                                                                      Per ENU per week
                                                                                         Basiotis et al.         1977-78 NFCS-LI      At-home                  FSP-eligible       Participant vs.   Participation dummy    Multivariate regression
                                                                                         (1983)                                       Nonpurchased food        households         nonparticipant
                                                                                                                                      included                 (n=3,562)
                                                                                                                                      Per household per week
                                                                                         Price (1983)            1973-74 BLS-CES      At-home                  All households     Participant vs.   Participation dummy;   Multivariate regression
                                                                                                                                      Purchased food only      (n=10,359)         nonparticipant;   benefit amount
                                                                                                                                      Per equivalent                              also dose-
                                                                                                                                      adult per week                              response
                                                                                         Salathe (1980)          1973-74 BLS-CES      At-home, away, total     FSP-eligible       Participant vs.   Participation dummy;   Multivariate regression
                                                                                                                                      Purchased food only      households         nonparticipant;   benefit amount
                                                                                                                                      Per person per week      (n=2,254)          also dose-
                                                                                                                                                                                  response
                                                                                         Group IB: Participant vs. nonparticipant comparisons—State and local studies
                                                                                         Lane (1978)             Kern County, CA      At-home                  FSP-eligible       Participant vs.   Participation dummy    Bivariate comparisons
                                                                                                                 (1972-73)            Nonpurchased food        households         nonparticipant                           based on proportion of
                                                                                                                                      included                 (n=329)                                                     income spent on food
                                                                                                                                      Per person per month
Economic Research Service/USDA




                                                                                         West et al. (1978)      Washington State     At-home                  FSP-eligible       Participant vs.   Participation dummy;   Weighted multivariate
                                                                                                                 (1972-73)            Nonpurchased food        households with    nonparticipant;   bonus amount           regression
                                                                                                                                      included                 child age 8-12     also dose-
                                                                                                                                                                                           4
                                                                                                                                      Per equivalent           (n=332)            response
                                                                                                                                      adult per month
                                                                                           See notes at end of table.                                                                                                                          Continued—
                                                                                         Appendix table 1—Studies that examined the impact of the Food Stamp Program on household food expenditures—Continued
Economic Research Service/USDA



                                                                                                                                            Measure of              Population                            Measure of
                                                                                                                                  1                     2
                                                                                         Study                          Data source        expenditures           (sample size)          Design           participation          Analysis method

                                                                                         Group II A: Dose-response estimates—Secondary analysis of national surveys
                                                                                         Kramer-LeBlanc          1989-91 CSFII        At-home, total           FSP participant       Dose-response   Benefit amount         Multivariate regression
                                                                                         et al. (1997)                                Purchased food only      households
                                                                                                                                      Per household per week   (n=790)
                                                                                         Levedahl (1991)         1979-80 NFCS-LI      At-home, total           FSP participants      Dose-response   Bonus value            Multivariate regression
                                                                                                                                      Purchased food only      who used all their
                                                                                                                                                               food stamps
                                                                                                                                                               (n=1,210)
                                                                                         Fraker et al.           1985 CSFII           Expenditures on food     FSP- and WIC-         Dose-response   Participation dummy;   Multivariate regression
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                         (1990)                                       during previous 2        eligible households                   benefit amount
                                                                                                                                      months                   (n=515)
                                                                                         Devaney and             1977-78 NFCS-LI      Aided recall of food     FSP-eligible          Dose-response   Participation dummy;   Multivariate regression
                                                                                         Fraker (1989)                                used in last 7 days      households                            bonus value
                                                                                                                                                               (n=4,473)
                                                                                         Basiotis et al.         1977-78 NFCS-LI      At-home                  FSP-eligible          Dose-response   Participation dummy;   Simultaneous equations
                                                                                         (1987)                                       Nonpurchased food        households                            bonus value            for food cost/nutrient
                                                                                                                                      included                 (n~3,000)                                                    availability/nutrient intake
                                                                                                                                      Per household per week                                                                relationship
                                                                                         Senauer and             1978 PSID            At-home                  FSP participant       Dose-response   Bonus value            Multivariate regression
                                                                                         Young (1986)                                 Purchased food only      households
                                                                                                                                      Per household per        (n=573)
                                                                                                                                      month
                                                                                         Smallwood and           1977-78 NFSC-LI      At-home                  FSP-eligible          Dose-response   Participation dummy;   2-equation selection-
                                                                                         Blaylock (1985)                              Purchased food only      households                            expected weekly        bias model
                                                                                                                                      Per person per week      (n=3,582)                             bonus value
                                                                                         West (1984)             1973-74 BLS-CES      At-home, away, total     FSP-eligible          Dose-response   Participation dummy;   Multivariate regression
                                                                                                                                      Purchased food only      households                            bonus value
                                                                                                                                      Per equivalent           (n=2,407)
                                                                                                                                      adult per week
                                                                                         Allen and Gadson        1977-78 NFCS-LI      At home, away, total     FSP-eligible          Dose-response   Bonus value            Multivariate regression
                                                                                         (1983)                                       Purchased food only      households
                                                                                                                                      Per household per week   (n=3,850)
                                                                                         Chen (1983)             1977-78 NFCS-LI      Aided recall of food     FSP participant       Dose-response   Participation dummy;   Multivariate regression
                                                                                                                                      used in last 7 days      households                            bonus value
                                                                                                                                                               (n=1,809)
                                                                                           See notes at end of table.                                                                                                                        Continued—
47
                                                                                         Appendix table 1—Studies that examined the impact of the Food Stamp Program on household food expenditures—Continued
48



                                                                                                                                             Measure of               Population                          Measure of
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                 1                       2
                                                                                         Study                         Data source          expenditures            (sample size)        Design           participation          Analysis method

                                                                                         Brown et al.           1977-78 NFCS-LI        Aided recall of food      FSP participant     Dose-response   Bonus value            Multivariate regression
                                                                                         (1982)                                        used in last 7 days       households
                                                                                                                                                                 (n=911)
                                                                                         Chavas and             1972-73 BLS-CES        At-home                   FSP-eligible        Dose-response   Bonus value            Seemingly unrelated
                                                                                         Yeung (1982)                                  Purchased food only       households,                                                regression model,
                                                                                                                                       Per household per week    southern region                                            interactions between
                                                                                                                                                                 (n=659)                                                    bonus value and
                                                                                                                                                                                                                                                 5
                                                                                                                                                                                                                            demographic variables
                                                                                         Johnson et al.         1977-78 NFCS-LI        At-home                   Low-income          Dose-response   Participation dummy;   Multivariate regression
                                                                                         (1981)                                        Nonpurchased food         households                          bonus value
                                                                                                                                       included                  (n=4,535)
                                                                                                                                       Per household per week
                                                                                         Benus et al.           1968-72 PSID           Annual expenditures for   All households      Dose-response   Participation dummy;   Dynamic adjustment
                                                                                         (1976)                                        food used at home         (n~3,300)                           bonus value            model
                                                                                         Hymans and             1968-72 PSID           Annual expenditures for   All households      Dose-response   Participation dummy;   Multivariate regression
                                                                                         Shapiro (1976)                                food used at home         (n~3,300)                           bonus value
                                                                                         Group IIB: Dose-response estimates—State and local studies
                                                                                         Breunig et al.         San Diego cashout      At-home                   FSP participant     Dose-response   Benefit amount         Multivariate regression
                                                                                         (2001)                 demonstration          Purchased food only       households
                                                                                                                (1990)                 Per person per month      receiving coupons
                                                                                                                                                                 (n=487)
                                                                                         Levedahl (1995)        San Diego cashout      At-home                   FSP participant     Dose-response   Benefit amount         Multivariate regression
                                                                                                                demonstration          Purchased food only       households
                                                                                                                (1990)                 Per person per month      receiving coupons
                                                                                                                                                                 (n=494)
                                                                                         Ranney and             Counties and           At-home                   FSP-eligible        Dose-response   Participation dummy;   Multivariate regression
Economic Research Service/USDA




                                                                                         Kushman (1987)         county groups in       Nonpurchased food         households                          bonus value
                                                                                                                California, Indiana,   included                  (n=896)
                                                                                                                Ohio, Virginia
                                                                                                                (1979-89)
                                                                                         Neenan and             Polk County, FL        At-home                   FSP participant     Dose-response   Participation dummy    Multivariate regression
                                                                                         Davis (1977)           (1976)                 Purchased food only       households
                                                                                                                                       Per household per         (n=123)
                                                                                                                                       month
                                                                                          See notes at end of table.                                                                                                                       Continued—
Economic Research Service/USDA

                                                                                         Appendix table 1—Studies that examined the impact of the Food Stamp Program on household food expenditures—Continued
                                                                                                                                           Measure of             Population                             Measure of
                                                                                                                                 1                     2
                                                                                         Study                         Data source        expenditures          (sample size)          Design            participation        Analysis method

                                                                                         West and               Washington State     At-home                 Households with       Dose-response     Bonus value         Multivariate regression
                                                                                                                                                                               6
                                                                                         Price (1976)           (1972-73)            Nonpurchased food       children ages 8-12
                                                                                                                                     included                (n=995)
                                                                                                                                     Per equivalent
                                                                                                                                     adult per month
                                                                                         Group IIIA: Cashout demonstrations—Experimental design
                                                                                         Fraker et al.          Alabama cashout      At-home, away, total    FSP participants      Random            Group membership    Multivariate regression
                                                                                         (1992)                 demonstration        Purchased food only     (n=2,386)             assignment of     dummy; benefit
                                                                                                                (1990)               and nonpurchased                              participants to   amount
                                                                                                                                     food included                                 check or coupon
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                     Per household, ENU,
                                                                                                                                     and AME per month
                                                                                         Ohls et al. (1992)     San Diego cashout    At-home, away, total    FSP participants      Random            Group membership    Multivariate regression
                                                                                                                demonstration        Purchased food only     (n=1,143)             assignment of     dummy; benefit
                                                                                                                (1990)               and nonpurchased food                         participants to   amount
                                                                                                                                     included                                      check or coupon
                                                                                                                                     Per household, ENU,
                                                                                                                                     and AME per month
                                                                                         Group IIIB: Cashout demonstrations—Nonexperimental design
                                                                                         Cohen and              Washington State     At-home, away, total    Households            Comparison of     Group membership    Multivariate regression
                                                                                         Young (1993)           cashout              Purchased food only     participating in      treatment and     dummy; benefit
                                                                                                                demonstration        and nonpurchased food   AFDC and who          matched           amount
                                                                                                                                                                               7
                                                                                                                (1990)               included                applied after FIP     comparison
                                                                                                                                     Per household, ENU,     implementation        counties
                                                                                                                                     and AME per month       (n=780)
                                                                                         Davis and              Alabama ASSETS       At-home, away, total    ASSETS and            Comparison of     Group membership    Multivariate regression
                                                                                         Werner (1993)          demonstration        Purchased food only     FSP participants      treatment and     dummy; benefit
                                                                                                                (1990)               Per household and       (n=1,371)             matched           amount
                                                                                                                                     AME per month                                 comparison
                                                                                                                                                                                   counties
                                                                                          See notes at end of table.                                                                                                                    Continued—
49
                                                                                         Appendix table 1—Studies that examined the impact of the Food Stamp Program on household food expenditures—Continued
50



                                                                                                                                                 Measure of                    Population                                      Measure of
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                  1                          2
                                                                                         Study                      Data source                 expenditures                 (sample size)              Design                 participation                Analysis method

                                                                                         Beebout et al.         1977 Puerto Rico          At-home, total                 Participant and           Pre-cashout           Group membership             2-equation selection-
                                                                                         (1985)                 supplement to the         Nonpurchased food              FSP-eligible              compared with         dummy; participation         bias models
                                                                                                                NFCS and 1984             included                       nonparticipant            cashout               dummy; benefit
                                                                                                                Puerto Rico HFCS          Per household and              households using          (1977 vs. 1984)       amount
                                                                                                                                          AME per week                   1977 eligibility
                                                                                                                                                                         criteria (n= 3,995)
                                                                                           1
                                                                                             Data sources:
                                                                                                ASSETS = Avenues to Self-Sufficiency through Employment and Training Services.
                                                                                                BLS-CES = Bureau of Labor Statistics’ Consumer Expenditure Survey.
                                                                                                CSFII = Continuing Survey of Food Intakes by Individuals.
                                                                                                HFCS = Household Food Consumption Survey.
                                                                                                NFCS = Nationwide Food Consumption Survey.
                                                                                                NFCS-LI = Nationwide Food Consumption Survey - Low Income Supplement.
                                                                                                PSID = Panel Study of Income Dynamics.
                                                                                           2
                                                                                             Includes indications of whether the dependent variable corresponds to food consumed at home, food consumed away from home, or all food; whether measure(s) represent only food
                                                                                         purchased with cash, credit, or food stamp coupons or include the estimated dollar value of home-grown food, gifts, etc.; whether expenditures are measured per person, per household, per
                                                                                         adult male equivalent (AME), per equivalent adult, or per equivalent nutrition unit (ENU); and the time unit for expenditures.
                                                                                           3
                                                                                             Does not treat FSP as endogenous.
                                                                                           4
                                                                                             Eligible participants were isolated in the nonparticipant group.
                                                                                           5
                                                                                             Main effects were not reported.
                                                                                           6
                                                                                             Eligible participants not isolated in the nonparticipant group.
                                                                                           7
                                                                                             FIP = Family Independence Program.
Economic Research Service/USDA
                                                                                         Appendix table 2—Studies that examined the impact of the Food Stamp Program on household availability of food energy and nutrients
Economic Research Service/USDA



                                                                                                                                            Data collection             Population                           Measure of
                                                                                         Study                          Data source1           method                 (sample size)        Design            participation          Analysis method

                                                                                         Group IA: Participant vs. nonparticipant comparisons—Secondary analysis of national surveys
                                                                                         Hama and                1977-78               Aided recall for food use   FSP-eligible       Participant vs.   Participation dummy    Simultaneous food
                                                                                         Chern (1988)            NFCS elderly          from household supply       households with    nonparticipant                           expenditure/nutrient
                                                                                                                                                                                                                                                     2
                                                                                                                 supplement            (7 days)                    elderly members                                             availability equation
                                                                                                                                                                   (n=1,454)
                                                                                         Kisker and              1979-80 NFCS-LI       Record of household         FSP-eligible       Participant vs.   Participation dummy    Bivariate t-tests
                                                                                         Devaney (1988)                                food use (7 days)           households         nonparticipant
                                                                                                                                                                   (n~2,900)
                                                                                         Allen and               1977-78 NFCS-LI       Aided recall for food use   FSP-eligible       Participant vs.   Participation dummy    Multivariate regression
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                         Gadson (1983)                                 from household supply       households         nonparticipant
                                                                                                                                       (7 days)                    (n=3,850)
                                                                                         Basiotis et al.         1977-78 NFCS-LI       Aided recall for food use   FSP-eligible       Participant vs.   Participation dummy    Multivariate regression
                                                                                         (1983)                                        from household supply       households         nonparticipant
                                                                                                                                       (7 days)                    (n=3,562)
                                                                                         Scearce and             1972-73 BLS-CES       Food category amount        FSP-eligible,      Participant vs.   Participation dummy    Multivariate regression
                                                                                         Jensen (1979)                                 and expenditure diary       southern region    nonparticipant
                                                                                                                                                                   (n=1,360)
                                                                                         Group IB: Participant vs. nonparticipant comparisons—Local studies
                                                                                         Lane (1978)             Kern County, CA       24-hour recall of food      FSP-eligible       Participant vs.   Participation dummy    Bivariate comparisons
                                                                                                                 (1972-73)             consumed at home            households         nonparticipant
                                                                                                                                                                   (n=329)
                                                                                         Group II: Dose-response estimates—Secondary analysis of national surveys
                                                                                         Devaney and             1979-80 NFCS-LI       Record of household         FSP-eligible       Dose-response     Benefit amount         Multivariate regression;
                                                                                         Moffitt (1991)                                food use (7 days)           households                                                  selection-bias models
                                                                                                                                                                   (n=2,925)
                                                                                         Basiotis et al.         1977-78 NFCS-LI       Aided recall for food use   FSP-eligible       Dose-response     Participation dummy;   Simultaneous equations
                                                                                         (1987)                                        from household supply       households                           bonus value            for food cost/nutrient
                                                                                                                                       (7 days)                    (n~3,000)                                                   availability/nutrient intake
                                                                                                                                                                                                                               relationship
                                                                                         Johnson et al.          1977-78 NFCS-LI       Aided recall for food use   Low-income         Dose-response     Participation dummy;   Multivariate regression
                                                                                         (1981)                                        from household supply       households                           bonus value
                                                                                                                                       (7 days)                    (n=4,535)
                                                                                           See notes at end of table.                                                                                                                              Continued—
51
                                                                                         Appendix table 2—Studies that examined the impact of the Food Stamp Program on household availability of food energy and nutrients—Continued
52



                                                                                                                                           Data collection               Population                            Measure of
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                         Study                   Data source1                 method                   (sample size)        Design             participation          Analysis method

                                                                                         Group IIIA: Cashout demonstrations—Experimental design
                                                                                         Bishop et al.        Alabama cashout        7-day food use from          Alabama FSP           Random            Group membership       Stochastic dominance
                                                                                         (2000)               demonstration          records and recall           participants          assignment of     dummy                  methods
                                                                                                              (1990) and                                          (n=2,184)             participants to
                                                                                                              San Diego cashout                                                         check or coupon
                                                                                                              demonstration                                       San Diego FSP
                                                                                                              (1990)                                              participants
                                                                                                                                                                  (n=935)
                                                                                         Fraker et al.        Alabama cashout        7-day food use from          FSP participants      Random            Group membership       Multivariate regression
                                                                                         (1992)               demonstration          records and recall           (n=2,386)             assignment of     dummy; benefit
                                                                                                              (1990)                                                                    participants to   amount
                                                                                                                                                                                        check or coupon
                                                                                         Ohls et al. (1992)   San Diego cashout      7-day food use from          FSP participants      Random            Group membership       Multivariate regression
                                                                                                              demonstration          records and recall           (n=1,143)             assignment of     dummy; benefit
                                                                                                              (1990)                                                                    participants to   amount
                                                                                                                                                                                        check or coupon
                                                                                         Group IIIB: Cashout demonstrations—Nonexperimental design
                                                                                         Cohen and            Washington State       7-day food use from          Households            Comparison of     Group membership       Multivariate regression
                                                                                         Young (1993)         cashout                records and recall           participating in      treatment and     dummy; benefit
                                                                                                              demonstration                                       AFDC and who          matched           amount
                                                                                                                                                                                    3
                                                                                                              (1990)                                              applied after FIP     comparison
                                                                                                                                                                  implementation        counties
                                                                                                                                                                  (n=780)
                                                                                         Beebout et al.       1977 Puerto Rico       7-day food use from          Participant and       Pre-cashout       Group membership       2-equation selection-
                                                                                         (1985)               supplement to the      records and recall           FSP-eligible          compared with     dummy; participation   bias models
                                                                                                              NFCS and 1984                                       nonparticipant        cashout           dummy; benefit
                                                                                                              Puerto Rico HFCS                                    households using      (1977 vs. 1984)   amount
                                                                                                                                                                  1977 eligibility
Economic Research Service/USDA




                                                                                                                                                                  criteria (n= 3,995)
                                                                                          1
                                                                                            Data sources:
                                                                                               BLS-CES = Bureau of Labor Statistics’ Consumer Expenditure Study.
                                                                                               HFCS = Household Food Consumption Survey.
                                                                                               NFCS = Nationwide Food Consumption Survey.
                                                                                               NFCS-LI = Nationwide Food Consumption Survey - Low Income Supplement.
                                                                                          2
                                                                                            Does not treat FSP as endogenous.
                                                                                          3
                                                                                            FIP = Family Independence Program.
                                                                                         Appendix table 3—Studies that examined the impact of the Food Stamp Program on dietary intakes of individuals
Economic Research Service/USDA



                                                                                                                                          Data collection        Population                             Measure of
                                                                                                                                 1
                                                                                         Study                         Data source           method            (sample size)          Design            participation              Analysis method

                                                                                         Group IA: Participant vs. nonparticipant comparisons—Secondary analysis of national surveys
                                                                                         Dixon (2002)           1988-94              24-hour recall         Adults ages 20 and   Participant vs.   Participation dummy        Multivariate regression
                                                                                                                NHANES-III                                  older (n=10,545)     nonparticipant
                                                                                         Bhattacharya and       1988-94              24-hour recall         Youth ages 12-16     Participant vs.   Participation dummy        Multivariate regression
                                                                                         Currie (2000)          NHANES-III           and nonquantified      (n=1,358)            nonparticipant
                                                                                                                                     food frequency
                                                                                         Wilde et al.           1994-96 CSFII        2 nonconsecutive       Low-income           Participant vs.   Participation dummy        Maximum likelihood
                                                                                         (1999)                                      24-hour recalls        individuals          nonparticipant                               estimation
                                                                                                                                                            (n=1,901)
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                         Weimer (1998)          1989-91 CSFII        24-hour recall         Elderly              Participant vs.   Participation dummy        Multivariate regression
                                                                                                                                     followed by 2 days     individuals          nonparticipant
                                                                                                                                     of food records        (n=1,566)
                                                                                         Cook et al. (1995)     1986 CSFII-LI        24-hour recall         Children ages 1-5    Participant vs.   Participation dummy        Bivariate chi-squared tests
                                                                                                                                     followed by 2 days     in households        nonparticipant
                                                                                                                                     of food records        under 125%
                                                                                                                                                                      2
                                                                                                                                                            of poverty
                                                                                         Rose et al. (1995)     1989-91 CSFII        24-hour recall         Children ages 1-5    Participant vs.   Participation dummy        Multivariate regression
                                                                                                                                     followed by 2 days     (n=800)              nonparticipant                               (weights not used)
                                                                                                                                     of food records
                                                                                         Bishop et al.          1977-78 NFCS-LI      24-hour recall         FSP-eligible         Participant vs.   Participation dummy        Stochastic dominance
                                                                                         (1992)                                      followed by 2 days     individuals          nonparticipant                               methods
                                                                                                                                     of food records        (n=2,590)
                                                                                         Fraker et al.          1985 CSFII           4 nonconsecutive       WIC-eligible         Participant vs.   Participation dummy        Multivariate regression
                                                                                         (1990)                                      24-hour recalls        women ages 19-50     nonparticipant                               and bivariate selection
                                                                                                                                                            (n=381) and their                                                 model
                                                                                                                                                            children ages 1-5
                                                                                                                                                            (n=818)
                                                                                         Gregorio and           1971-73 NHANES-I     24-hour recall         Preschool children   Participant vs.   Participation dummy;       Bivariate and
                                                                                         Marshall (1984)                                                    (n=2,774),           nonparticipant    participation interacted   multivariate regression
                                                                                                                                                            School-aged                            with poverty index ratio
                                                                                                                                                            children (n=3,509)
                                                                                         Lopez and              1971-73 NHANES-I     24-hour recall         Low-income           Participant vs.   Participation dummy        Multivariate analysis of
                                                                                         Habicht (1987a,        and 1976-80                                 elderly (n=1,684     nonparticipant                               variance
                                                                                         1987b)                 NHANES-II                                   and n=1,388)
                                                                                          See notes at end of table.                                                                                                                          Continued—
53
                                                                                         Appendix table 3—Studies that examined the impact of the Food Stamp Program on dietary intakes of individuals—Continued
54



                                                                                                                                               Data collection        Population                               Measure of
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                  1
                                                                                         Study                          Data source               method            (sample size)            Design            participation          Analysis method

                                                                                         Group IB: Participant vs. nonparticipant comparisons—State and local studies
                                                                                         Fey-Yensan et al.       Low-income areas         Food frequency         Low-income elderly     Participant vs.   Participation dummy    Chi-square tests and
                                                                                         (2003)                  in Connecticut           questionnaire          living in subsidized   nonparticipant                           analysis of variance
                                                                                                                 (1996-97)                                       housing (82%
                                                                                                                                                                 female) (n=200)
                                                                                         Perez-Escamilla         2 pediatric clinics in   24-hour recall and     Children ages 8        Participant vs.   Participation dummy    Multivariate regression
                                                                                         et al. (2000)           low-income areas of      2 food frequency       months to 5 years      nonparticipant
                                                                                                                 Hartford, CT (1999)      questionnaires         who were
                                                                                                                                                                 participating in WIC
                                                                                                                                                                 or who had
                                                                                                                                                                 participated in past
                                                                                                                                                                 year (n=99)
                                                                                         Perkin et al.           1 urban family           24-hour recall         Women ages             Participant vs.   Participation dummy    Bivariate t-tests
                                                                                         (1988)                  practice center in                              18-45 (n=102)          nonparticipant
                                                                                                                 Florida (dates for
                                                                                                                 data collection not
                                                                                                                 reported)
                                                                                         Posner et al.           1980-81                  24-hour recall         Elderly                Participant vs.   Participation dummy    Multivariate regression
                                                                                         (1987)                  FNS SSI/ECD              via telephone          (n=1,900)              nonparticipant
                                                                                         Butler et al.           1980-81                  24-hour recall         Low-income elderly     Participant vs.   Participation dummy    Multivariate regression
                                                                                         (1985)                  FNS SSI/ECD              via telephone          individuals            nonparticipant                           with selection-bias
                                                                                                                                                                 (n=1,684)                                                       technique
                                                                                         Futrell et al.          1 county in              4-day record           Black children         Participant vs.   Participation dummy    Bivariate t-tests
                                                                                         (1975)                  Mississippi (1971)                              ages 4-5 (n=96)        nonparticipant
                                                                                         Group IIA: Dose-response estimates—Secondary analysis of national surveys
                                                                                         Gleason et al.          1994-96                  2 nonconsecutive       Low-income             Dose-response     Benefit amount         Comparison of
                                                                                         (2000)                  CSFII/DHKS               24-hour recalls        individuals                                                     regression-adjusted
Economic Research Service/USDA




                                                                                                                                                                 (n=3,935)                                                       means
                                                                                         Basiotis et al.         1989-91 CSFII            24-hour recall         Low-income             Dose-response     Participation dummy;   Multivariate regression
                                                                                         (1998)                                           followed by 2 days     households                               benefit amount
                                                                                                                                          of food records        (n=1,379)
                                                                                           See notes at end of table.                                                                                                                                Continued—
                                                                                         Appendix table 3—Studies that examined the impact of the Food Stamp Program on dietary intakes of individuals—Continued
Economic Research Service/USDA



                                                                                                                                           Data collection        Population                            Measure of
                                                                                                                                  1
                                                                                         Study                          Data source           method            (sample size)          Design           participation              Analysis method

                                                                                         Rose et al.             1989-91 CSFII        24-hour recall         Nonbreastfeeding      Dose-response   Benefit amount             Multivariate regression;
                                                                                         (1998a)                                      followed by 2 days     preschoolers                                                     investigated selection bias
                                                                                                                                      of food records        (n=499)
                                                                                         Kramer-LeBlanc          1989-91 CSFII        24-hour recall         FSP-eligible          Dose-response   Benefit amount             Multivariate regression
                                                                                         et al. (1997)                                followed by 2 days     individuals
                                                                                                                                      of food records        (n=793)
                                                                                         Akin et al. (1987)      1977-78 NFCS         24-hour recall         Elderly               Dose-response   Participation dummy;       Multivariate regression
                                                                                                                 elderly supplement   followed by 2 days     individuals                           bonus value;
                                                                                                                                      of food records        (n=5,615)                             participation interacted
                                                                                                                                                                                                   with social security
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                                                                   income
                                                                                         Basiotis et al.         1977-78 NFCS-LI      24-hour recall         FSP-eligible          Dose-response   Participation dummy;       Simultaneous
                                                                                         (1987)                                       followed by 2 days     individuals                           bonus value                equations for food
                                                                                                                                      of food records        (n=3,000)                                                        cost/nutrient availability/
                                                                                                                                                                                                                              nutrient intake relationship
                                                                                         Akin et al. (1985)      1977-78 NFCS         24-hour recall         Elderly               Dose-response   Participation dummy;       Multivariate switching
                                                                                                                 elderly supplement   followed by 2 days     individuals                           bonus value                regression model
                                                                                                                                      of food records        (n=1,315)
                                                                                         Group IIB: Dose-response estimates—State and local studies
                                                                                         Butler and              1980-81              24-hour recall         Low-income            Dose-response   Participation dummy;       Multivariate
                                                                                         Raymond                 FNS SSI/ECD          via telephone          elderly individuals                   bonus value                endogenous
                                                                                         (1996)                  and 1969-73 RIME     and in-person          (n=1,542)                                                        switching model
                                                                                                                                                             Low-income                                                       with selection-
                                                                                                                                                             individuals in                                                   bias adjustment
                                                                                                                                                             rural areas
                                                                                                                                                             (n=1,093)
                                                                                           See notes at end of table.                                                                                                                         Continued—
55
56

                                                                                         Appendix table 3—Studies that examined the impact of the Food Stamp Program on dietary intakes of individuals—Continued
                                                                                                                                            Data collection              Population                              Measure of
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                               1
                                                                                         Study                    Data source                  method                  (sample size)             Design          participation          Analysis method

                                                                                         Whitfield (1982)     Tulsa, OK (1978)         24-hour recall               FSP-eligible            Dose-response   Participation dummy;   Multivariate regression
                                                                                                                                                                    individuals                             bonus value
                                                                                                                                                                    (n=195)
                                                                                         West et al.          Washington State         Unspecified                  Children ages 8-12      Dose-response   Bonus value            Multivariate regression
                                                                                         (1978)               (1972-73)                                             (n=728)
                                                                                          1
                                                                                            Data sources:
                                                                                              CSFII = Continuing Survey of Food Intakes by Individuals.
                                                                                              DHKS = Diet and Health Knowledge Survey.
                                                                                              FNS SSI/ECD = Food and Nutrition Service Supplementary Security Income/Elderly Cashout Demonstration.
                                                                                              NFCS = Nationwide Food Consumption Survey.
                                                                                              NFCS-LI = Nationwide Food Consumption Survey - Low Income Supplement.
                                                                                              NHANES = National Health and Nutrition Examination Survey.
                                                                                              RIME = Rural Income Maintenance Experiment.
                                                                                          2
                                                                                            Sample size not stated.
Economic Research Service/USDA
                                                                                         Appendix table 4—Studies that examined the impact of the Food Stamp Program on other nutrition and health outcomes
Economic Research Service/USDA



                                                                                                                                                        Population sample
                                                                                                                                           1
                                                                                         Study                               Data source                  (sample size)                  Design    Measure of participation       Analysis method

                                                                                         Food security: Participant vs. nonparticipant comparisons
                                                                                         Huffman and                   1997 longitudinal             Low-income households      Participant vs.    Participation dummy        Simultaneous equation
                                                                                         Jensen (2003)                 SPD and 1998                  (n=3,733)                  nonparticipant                                model with 3 probits
                                                                                                                       experimental SPD
                                                                                         Jensen (2002)                 2000 April                    FSP and FSP-eligible       Participant vs.    Participation dummy        Bivariate ordered probit
                                                                                                                       FSS-CPS                       households (n=6,300)       nonparticipant                                model
                                                                                         Gunderson and                 1991 and 1992 SIPP            Low-income households      Participant vs.    Participation dummy        Simultaneous equation
                                                                                         Oliveria (2001)                                             (n=3,452)                  nonparticipant                                model with 2 probits
                                                                                         Bhattacharya and              1988-94 NHANES-III            Youth ages 12-16           Participant vs.    Participation dummy        Multivariate regression
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                         Currie (2000)                                               (n=1,358)                  nonparticipant
                                                                                         Perez-Escamilla               2 pediatric clinics in low-   Children ages 8 months     Participant vs.    Participation dummy        Chi-square analysis
                                                                                         et al. (2000)                 income areas of Hartford,     to 5 years who were        nonparticipant
                                                                                                                       CT (1999)                     participating in WIC or
                                                                                                                                                     had participated in past
                                                                                                                                                     year (n=99)
                                                                                         Cohen et al. (1999)           1996-97 NFSPS                 Low-income households      Participant vs.    Participation dummy        Comparisons of
                                                                                                                                                     (n=3,228)                  nonparticipant                                proportions
                                                                                         Alaimo et al. (1998)          1988-94 NHANES-III            Low-income households      Participant vs.    Participation dummy        Logistic regression
                                                                                                                                                     (n=5,285)                  nonparticipant                                (survey weights)
                                                                                         Hamilton et al. (1997)        1995 CPS                      Low-income households      Participant vs.    Participation dummy        Comparison of
                                                                                                                                                     (n=21,810)                 nonparticipant                                proportions
                                                                                         Cristofar and                 1985-86 CSFII-LI              Low-income women           Participants vs.   Participation dummy;       Multivariate regression
                                                                                         Basiotis (1992)                                             (n=3,398) and low-         nonparticipant     benefit amount
                                                                                                                                                     income children ages 1-5
                                                                                                                                                     years (n=1,930)
                                                                                         Kisker and                    1979-80 NFCS-LI               Low-income (n~2,900)       Participant vs.    Participation dummy        Bivariate t-tests
                                                                                         Devaney (1988)                                                                         nonparticipant
                                                                                          See notes at end of table.                                                                                                                         Continued—
57
                                                                                         Appendix table 4—Studies that examined the impact of the Food Stamp Program on other nutrition and health outcomes—Continued
58



                                                                                                                                                   Population sample
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                        1
                                                                                         Study                              Data source              (sample size)                  Design            Measure of participation       Analysis method

                                                                                         Food security: Dose-response estimates
                                                                                         Rose et al. (1998b)           1989-91 CSFII           All households (n=6,620     Dose-response              Annual dollar amount       Logistic regression
                                                                                                                       and 1992 SIPP           and n=30,303)                                          of food stamps
                                                                                         Food security: Cashout demonstrations
                                                                                         Fraker et al. (1992)          Alabama cashout         FSP participants            Random assignment          Group membership           Multivariate regression
                                                                                                                       demonstration (1990)    (n=2,386)                   of participants to check   dummy and benefit
                                                                                                                                                                           or coupon                  amount
                                                                                         Ohls et al. (1992)            San Diego cashout       FSP participants            Random assignment          Group membership           Multivariate regression
                                                                                                                       demonstration (1990)    (n=1,143)                   of participants to check   dummy and benefit
                                                                                                                                                                           or coupon                  amount
                                                                                         Davis and                     Alabama ASSETS          ASSETS and FSP              Comparison of treatment    Group membership           Multivariate regression
                                                                                         Werner (1993)                 demonstration (1990)    participants (n=1,371)      and matched comparison     dummy and benefit
                                                                                                                                                                           counties                   amount
                                                                                         Birthweight: Participant vs. nonparticipant comparisons
                                                                                         Korenman and                  1979-88 NLSY            Infants born to poor        Participant vs.            Participation dummy        Multivariate regression;
                                                                                         Miller (1992)                                         women with 2 births         nonparticipant                                        fixed-effects models
                                                                                                                                               between 1979 and 1988
                                                                                                                                               (n~2,568)
                                                                                         Currie and Cole (1991)        1979-87 NLSY            Infants born to poor,       Participant vs.            Participation dummy        Multivariate 2-stage least
                                                                                                                                               young women (n~4,900)       nonparticipant                                        squares and fixed-effects
                                                                                                                                                                                                                                 model
                                                                                         Weight and/or height: Participant vs. nonparticipant comparisons
                                                                                         Fey-Yensan et al. (2003)      Low-income areas in     Low-income elderly living   Participant vs.            Participation dummy        Chi-square tests and
                                                                                                                       Connecticut (1996-97)   in subsidized housing       nonparticipant                                        analysis of variance
                                                                                                                                               (82% female) (n=200)
Economic Research Service/USDA




                                                                                         Gibson (2003)                 1985-96 NLSY            Low-income women,           Participant vs.            Participation dummy        Multivariate regression
                                                                                                                                                                    2
                                                                                                                                               ages 20-40 (n=13,390)       nonparticipant
                                                                                         Jones et al. (2003)           1997 PSID-CDS           Children ages 5-12 from     Participant vs.            Participation dummy        Multivariate regression
                                                                                                                                               households with incomes     nonparticipant
                                                                                                                                               <185% of poverty
                                                                                         Gibson (2001)                 1997                    Youth ages 12-17            Participant vs.            Participation dummy        Multivariate regression
                                                                                                                       NLSY-child supplement   (n=7,920)                   nonparticipant
                                                                                          See notes at end of table.                                                                                                                           Continued—
                                                                                         Appendix table 4—Studies that examined the impact of the Food Stamp Program on other nutrition and health outcomes—Continued
Economic Research Service/USDA



                                                                                                                                                           Population sample
                                                                                                                                            1
                                                                                         Study                                Data source                    (sample size)                       Design                Measure of participation       Analysis method
                                                                                         Bhattacharya and              1988-94 NHANES-III              Youth ages 12-16               Participant vs.                 Participation dummy         Multivariate regression
                                                                                         Currie (2000)                                                 (n=1,358)                      nonparticipant
                                                                                         Korenman and                  1986 and 1988                   Children ages 0-7              Participant vs.                 Participation dummy         Multivariate regression
                                                                                         Miller (1992)                 NLSY-child supplement           (n=6,598)                      nonparticipant
                                                                                         Nutritional biochemistries: Participant vs. nonparticipant comparisons
                                                                                         Dixon (2002)                  1988-94 NHANES-III              Adults ages 20 and older       Participant vs.                 Participation dummy         Multivariate regression
                                                                                                                                                       (n=10,545)                     nonparticipant (albumin,
                                                                                                                                                                                      hemoglobin, serum iron,
                                                                                                                                                                                      vitamin C, vitamin E,
                                                                                                                                                                                      carotenoids)
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                         Bhattacharya and              1988-94 NHANES-III              Youth ages 12-16               Participant vs.                 Participation dummy         Multivariate regression
                                                                                         Currie (2000)                                                 (n=1,358)                      nonparticipant (iron,
                                                                                                                                                                                      cholesterol, vitamin A,
                                                                                                                                                                                      vitamin C, vitamin E)
                                                                                         Lopez and Habicht             1971-73 NHANES-I and            Low-income elderly             Participant vs.                 Participation dummy         Multivariate ANOVA
                                                                                         (1987b)                       1976-80 NHANES-II               (n=1,684, NHANES-I)            nonparticipant (iron)
                                                                                                                                                       and (n=1,388,
                                                                                                                                                       NHANES-II)
                                                                                         General measures of nutrition or health status: Participant vs. nonparticipant comparisons
                                                                                         Fey-Yensan et al. (2003)      Low-income areas in             Low-income elderly living      Participant vs.                 Participation dummy         Chi-square tests and
                                                                                                                       Connecticut (1996-97)           in subsidized housing          nonparticipant                                              analysis of variance
                                                                                                                                                       (82% female) (n=200)
                                                                                         Gibson (2001)                 1997 NLSY                       Youth ages 12-17               Participant vs.                 Participation dummy         Multivariate regression
                                                                                                                                                       (n=7,920)                      nonparticipant
                                                                                          1
                                                                                            Data sources:
                                                                                              ASSETS = Avenues to Self-Sufficiency through Employment and Training Services.
                                                                                              FSS-CPS = Food Security Supplement of the Current Population Survey.
                                                                                              CPS = Current Population Survey.
                                                                                              CSFII = Continuing Survey of Food Intakes by Individuals.
                                                                                              CSFII-LI = Continuing Survey of Food Intakes by Individuals - Low-Income Samples.
                                                                                              NFCS-LI = Nationwide Food Consumption Survey - Low Income Supplement.
                                                                                              NFSPS = National Food Stamp Program Survey.
                                                                                              NHANES = National Health and Nutrition Examination Survey.
                                                                                              NLSY = National Longitudinal Survey of Youth.
                                                                                              PSID-CDS = Panel Study of Income Dynamics - Child Development Supplement.
                                                                                              SIPP = Survey of Income and Program Participation.
                                                                                              SPD = Survey of Program Dynamics.
                                                                                          2
                                                                                            Multiple observations for each person, collected annually between 1979 and 1994 and biannually thereafter. Sample size represents person-years.
59
                                              WIC Program




Economic Research Service/USDA   Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4   61
                                                                                         Appendix table 5—Studies that examined the impact of prenatal WIC participation on birth outcomes, including associated health care costs
62



                                                                                                                                                                         Population                                  Measure of
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                           1                         2
                                                                                         Study                         Outcome(s)             Data source              (sample size)             Design              participation             Analysis method

                                                                                         Group I: National evaluations
                                                                                         Rush et al.            Birthweight,            Vital statistics records    N/A                     Trends analysis     WIC penetration index     Multivariate regression
                                                                                         (1988a) (NWE)          gestational age,        for 1,392 counties in       (Aggregate data         relating WIC
                                                                                                                likelihood of low       19 States and DC            analysis)               program
                                                                                                                birthweight, very low   (1972-80)                                           penetration over
                                                                                                                birthweight, and                                                            time to birth
                                                                                                                premature birth, and                                                        outcomes
                                                                                                                neonatal and infant
                                                                                                                mortality rates
                                                                                         Rush et al.            Birthweight,            Record abstractions in      Nationally              Participant vs.     Participation dummy       Multivariate regression
                                                                                         (1988d) (NWE)          gestational age,        174 WIC sites and 55        representative          nonparticipant
                                                                                                                likelihood of           prenatal clinics(1983-84)   sample of pregnant
                                                                                                                premature birth, and                                WIC participants
                                                                                                                fetal mortality rate                                and income-eligible
                                                                                                                                                                    nonparticipants
                                                                                                                                                                    receiving prenatal
                                                                                                                                                                    care in surrounding
                                                                                                                                                                    public health clinics
                                                                                                                                                                    or hospitals
                                                                                                                                                                              3
                                                                                                                                                                    (n=3,935)
                                                                                         Edozien et al.         Birthweight,            Primary data collection     Postpartum WIC          Participants,       Newly enrolling           Multivariate regression
                                                                                         (1979)                 gestational age         in 19 WIC sites in 14       participants who        before vs. after,   participants vs.
                                                                                                                                        States. Data were           participated            separate groups     participants with
                                                                                                                                        collected at time of WIC    prenatally                                  varying lengths of
                                                                                                                                        enrollment,                 (n~1,000)                                   participation
                                                                                                                                        approximately every 3
                                                                                                                                        months until delivery,
                                                                                                                                        and once after delivery
                                                                                                                                        (1973-76)
Economic Research Service/USDA




                                                                                         Group II: Secondary analysis of national surveys
                                                                                         Finch (2003)           Likelihood of low       1988 NMIHS                  WIC and non-WIC         Participant vs.     Participation dummy       Multivariate regression
                                                                                                                birthweight                                         women who were          nonparticipant      with short- (<6 months)
                                                                                                                                                                    White, Black, or                            and long-term (6+
                                                                                                                                                                    Hispanic with live                          months) WIC
                                                                                                                                                                    singleton births that                       participation
                                                                                                                                                                    were at least 22
                                                                                                                                                                    weeks gestation
                                                                                                                                                                    (n=12,814)
                                                                                          See notes at end of table.                                                                                                                                     Continued—
Economic Research Service/USDA

                                                                                         Appendix table 5—Studies that examined the impact of prenatal WIC participation on birth outcomes, including associated
                                                                                         health care costs—Continued
                                                                                                                                                                Population                                 Measure of
                                                                                                                                                       1                    2
                                                                                         Study                          Outcome(s)          Data source       (sample size)             Design             participation              Analysis method

                                                                                         Kowaleski-Jones         Birthweight            1990-96 NLSY       (1) NLSY children       Participant vs.   Participation dummy         (1) Multivariate regression
                                                                                         and Duncan                                                        born between 1990       nonparticipant                                (2) Fixed-effects model
                                                                                         (2002)                                                            and 1996 (n=1,984)
                                                                                                                                                           (2) NLSY children
                                                                                                                                                           born between 1990
                                                                                                                                                           and 1996, with at
                                                                                                                                                           least 1 other sibling
                                                                                                                                                           born during the
                                                                                                                                                           same period
                                                                                                                                                           (n=453 sibling
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                           pairs)
                                                                                         Hogan and Park          Likelihood of low      1988 NMIHS         WIC and non-WIC         Participant vs.   Participation dummy         Multivariate regression
                                                                                         (2000)                  birthweight and very                      women (n=8,145)         nonparticipant
                                                                                                                 low birthweight
                                                                                         Brien and               Birthweight,           1988 NMIHS         (1) WIC and             Participant vs.   (1) Participation           (1) Multivariate regression,
                                                                                         Swann (1999)            likelihood of low                         income-eligible         nonparticipant    dummies: 1 for ever         including attempt to
                                                                                                                 birthweight and                           non-Hispanic                              participated and 1 for      control for simultaneity
                                                                                                                 premature birth, and                      women who were                            participated during first   and several selection-
                                                                                                                 neonatal and infant                       at nutritional risk                       trimester                   bias-adjustment models
                                                                                                                 mortality rates                           (n=7,778)                                 (2) Participation status    (2) Fixed-effects model;
                                                                                                                                                           (2) WIC and                               for each pregnancy          separate models
                                                                                                                                                           income-eligible                                                       estimated for Blacks and
                                                                                                                                                           non-Hispanic                                                          Whites
                                                                                                                                                           women with at least
                                                                                                                                                           1 live birth prior to
                                                                                                                                                           1988 (n=6,254
                                                                                                                                                           pairs of births)
                                                                                         Moss and Carver         Neonatal mortality     1988 NMIHS         WIC and income-         Participant vs.   Participation dummy         Logit analysis
                                                                                         (1998)                  rate                                      eligible non-           nonparticipant    with and without
                                                                                                                                                           Hispanic women                            Medicaid
                                                                                                                                                           (n=7,796)
                                                                                         Frisbie et al.          Likelihood of          1988 NMIHS         WIC and non-WIC         Participant vs.   Participation dummy         Multivariate
                                                                                         (1997)                  intrauterine growth                       women (n=8,424)         nonparticipants                               regression analysis to
                                                                                                                 retardation,                                                                                                    identify determinants of
                                                                                                                 premature birth, and                                                                                            birth outcomes
                                                                                                                                 4
                                                                                                                 heavy preemie
                                                                                           See notes at end of table.                                                                                                                             Continued—
63
64

                                                                                         Appendix table 5—Studies that examined the impact of prenatal WIC participation on birth outcomes, including associated
                                                                                         health care costs—Continued
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                                      Population                                Measure of
                                                                                                                                                         1                        2
                                                                                         Study                         Outcome(s)            Data source            (sample size)             Design            participation           Analysis method

                                                                                         Covington (1995)       Likelihood of low       1988 NMIHS                WIC and non-WIC        Participant vs.   Participation dummy     Multivariate regression.
                                                                                                                birthweight and very                              African American       nonparticipant                            Separate models for LBW
                                                                                                                low birthweight                                   women who                                                        vs. normal weight and
                                                                                                                                                                  received some                                                    VLBW vs. normal weight
                                                                                                                                                                  prenatal care                                                    for each of 4 subgroups
                                                                                                                                                                  (n=3,905)                                                        based on combinations of
                                                                                                                                                                                                                                   income and receipt of
                                                                                                                                                                                                                                   Medicaid and/or AFDC
                                                                                         Gordon and             Birthweight,            1988 NMIHS                WIC and income-        Participant vs.   Participation dummy     Multivariate regression
                                                                                         Nelson (1995)          gestational age,                                  eligible women         nonparticipant                            and logit analysis.
                                                                                                                likelihood of low                                 (n=6,170)                                                        Birthweight analysis
                                                                                                                birthweight, very low                                                                                              included separate models
                                                                                                                birthweight, and                                                                                                   for Blacks and Whites, as
                                                                                                                premature birth, and                                                                                               well as several alternative
                                                                                                                neonatal and infant                                                                                                models to control for
                                                                                                                                                                                                                                                 5, 6
                                                                                                                mortality rates                                                                                                    simultaneity.
                                                                                                                                                                                                                                   Attempted, but rejected,
                                                                                                                                                                                                                                   selection-bias adjustment.
                                                                                         Joyce et al.           Neonatal mortality      1977 Census data for      Data for 677           Cost-             State-specific number   Multivariate regression,
                                                                                         (1988)                 rate                    large counties in the     counties with          effectiveness     of pregnant women       including selection-bias
                                                                                                                                        U.S.                      50,000+ residents      study using       enrolled in WIC per     adjustment. Separate
                                                                                                                                                                  for White analysis     aggregate data    1,000 State-specific    models for Blacks
                                                                                                                                                                  and 357 counties                         eligible women          and Whites.
                                                                                                                                                                  with 5,000+ Blacks
                                                                                                                                                                  for Black analysis
                                                                                         Group III: State-level studies using WIC participation files matched with Medicaid and/or birth record files
                                                                                         Roth et al. (2004)     Likelihood of low       Linked WIC, Medicaid,     WIC and non-WIC        Participant vs.   Participation dummy     Multivariate regression
                                                                                                                birthweight, very low   and vital statistics      Medicaid recipients    nonparticipant
Economic Research Service/USDA




                                                                                                                birthweight,            records for births in     who did not
                                                                                                                neonatal mortality,     Florida between January   participate in high-
                                                                                                                postneonatal            1996 and the end of       risk obstetrical
                                                                                                                mortality, infant       December 2000             program
                                                                                                                          7
                                                                                                                mortality                                         (n=295,599)
                                                                                          See notes at end of table.                                                                                                                               Continued—
Economic Research Service/USDA

                                                                                         Appendix table 5—Studies that examined the impact of prenatal WIC participation on birth outcomes, including associated
                                                                                         health care costs—Continued
                                                                                                                                                                         Population                               Measure of
                                                                                                                                                           1                         2
                                                                                         Study                         Outcome(s)             Data source              (sample size)            Design            participation           Analysis method

                                                                                         Gregory and            Likelihood of low       Linked WIC, Medicaid,        WIC and non-WIC       Participant vs.   Participation dummy     Multivariate regression.
                                                                                         deJesus (2003)         birthweight, very low   birth and death record,      Medicaid recipients   nonparticipant                            Separate models for
                                                                                                                birthweight,            and hospital discharge       with live singleton                                             Blacks and non-Blacks
                                                                                                                neonatal mortality,     files for births in New      births (n=19,614)
                                                                                                                and infant mortality,   Jersey between May
                                                                                                                length of infants’      1992 and December
                                                                                                                hospital stay,          1993
                                                                                                                Medicaid costs
                                                                                         Buescher and           Birthweight,            Linked WIC, Medicaid,        WIC and non-WIC       Participant vs.   Participation dummy     Multivariate regression,
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                         Horton (2000)          likelihood of low       and birth record files for   Medicaid recipients   nonparticipant                            including several
                                                                                                                birthweight and very    1997 births in North         who were enrolled                                               alternative models to
                                                                                                                                                                                                                                                             8
                                                                                                                low birthweight,        Carolina                     in prenatal care                                                control for simultaneity
                                                                                                                Medicaid costs                                       and had live
                                                                                                                                                                     singleton births
                                                                                                                                                                     (n=42,965)
                                                                                         Ahluwalia et al.       Likelihood of           Linked WIC and birth         WIC and non-WIC       Participant vs.   Dose response:          Multivariate regression
                                                                                         (1998)                 low birthweight         record files for 1992        women with full-      nonparticipant    Length of prenatal
                                                                                                                                                                                                                            9
                                                                                                                                        births in Michigan           term births                             WIC “exposure”
                                                                                                                                                                     (n=53,782)
                                                                                         Buescher et al.        Likelihood of low       Linked WIC, Medicaid,        WIC and non-WIC       Participant vs.   Participation dummy     Multivariate regression,
                                                                                         (1993)                 birthweight and very    and birth record files       Medicaid recipients   nonparticipant    and dose-response:      including attempt to
                                                                                                                                                                                                                                                             10
                                                                                                                low birthweight,        for 1988 births in           who were enrolled                       Percentage of           control for simultaneity
                                                                                                                Medicaid costs          North Carolina               in prenatal care                        gestation on WIC
                                                                                                                                                                     (n=21,900)
                                                                                         Devaney and            Likelihood of           FNS WIC/Medicaid             WIC and non-WIC       Participant vs.   Participation           Probit analysis
                                                                                         Schirm (1993)          neonatal and infant     (1987-88)                    Medicaid recipients   nonparticipant    dummy: Enrolled by 30
                                                                                                                mortality                                            (n=111,958 )                            weeks gestation
                                                                                         Devaney (1992)         Likelihood of very      FNS WIC/Medicaid             WIC and non-WIC       Participant vs.   Participation dummy     Probit analysis, including
                                                                                                                low birthweight         (1987-88)                    Medicaid recipients   nonparticipant                            attempts to control for
                                                                                                                                                                                                                                                 11
                                                                                                                                                                     (n=111,958 )                                                    simultaneity
                                                                                         Devaney et al.         Birthweight,            FNS WIC/Medicaid             WIC and non-WIC       Participant vs.   Participation dummy     Multivariate regression
                                                                                         (1990/91)              gestational age,        (1987-88)                    Medicaid recipients   nonparticipant                            and probit analysis,
                                                                                                                likelihood of                                        (n=111,958 )                                                    including attempt to
                                                                                                                                                                                                                                                               12
                                                                                                                premature birth, and                                                                                                 control for simultaneity.
                                                                                                                Medicaid costs                                                                                                       Attempted but rejected
                                                                                                                                                                                                                                     selection-bias adjustment.
                                                                                          See notes at end of table.                                                                                                                                   Continued—
65
66

                                                                                         Appendix table 5—Studies that examined the impact of prenatal WIC participation on birth outcomes, including associated
                                                                                         health care costs—Continued
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                                           Population                                 Measure of
                                                                                                                                                           1                           2
                                                                                         Study                         Outcome(s)             Data source                (sample size)             Design             participation        Analysis method

                                                                                         New York State         Birthweight,            Linked WIC, birth             Singleton births to     Participant vs.    Participation dummy   Multivariate regression
                                                                                         (1990)                 gestational age,        record, and hospital          WIC and non-WIC         nonparticipant
                                                                                                                likelihood of low       discharge files for births    women                   within 3 groups
                                                                                                                birthweight, very low   in New York State in the      (n=132,994)             defined on the
                                                                                                                birthweight, and        last 6 months of 1988                                 basis of
                                                                                                                premature birth, and                                                          insurance
                                                                                                                Medicaid costs                                                                coverage
                                                                                                                                                                                              (Medicaid,
                                                                                                                                                                                              private, none)
                                                                                         Simpson (1988)         Likelihood of           Aggregate county-level        Data for 75 (of 100)    Trends analysis    Program “intensity”   Multivariate regression
                                                                                                                low birthweight         data for North Carolina,      counties, all of        relating WIC       variable based on
                                                                                                                                        including vital statistics,   which provided          penetration over   county-level WIC
                                                                                                                                        demographic and               WIC and other           time to birth      expenditures
                                                                                                                                        service infrastructure        prenatal care           outcomes
                                                                                                                                        characteristics, and          services for all
                                                                                                                                        program penetration and       county residents
                                                                                                                                        expenditures (1980-85)        (rather than sharing
                                                                                                                                                                      responsibility with
                                                                                                                                                                      another county)
                                                                                         Stockbauer             Birthweight,            Linked WIC, birth and         Matched WIC and         Participant vs.    Participation dummy   Analysis of covariance
                                                                                         (1987)                 gestational age,        death record files for        non-WIC women           matched control    and dose response:
                                                                                                                likelihood of low       1982 births in Missouri       with singleton births                      Dollar value of
                                                                                                                                                                                      13
                                                                                                                birthweight, very low                                 (n=9,411 pairs)                            redeemed vouchers
                                                                                                                birthweight,
                                                                                                                premature birth,
                                                                                                                small-for-
                                                                                                                gestational-age, and
                                                                                                                neonatal mortality
Economic Research Service/USDA




                                                                                         Schramm (1986)         Birthweight,            Linked WIC, Medicaid,         WIC and non-WIC         Participant vs.    Participation dummy   Multivariate regression
                                                                                                                likelihood of low       birth record, hospital        Medicaid recipients     nonparticipant     and dose response:
                                                                                                                birthweight,            care, and death record        (n=8,546)                                  WIC food costs
                                                                                                                neonatal mortality      files for 1982 births                                                    adjusted for length
                                                                                                                rate, and Medicaid      in Missouri                                                              of pregnancy
                                                                                                                costs
                                                                                          See notes at end of table.                                                                                                                                  Continued—
Economic Research Service/USDA

                                                                                         Appendix table 5—Studies that examined the impact of prenatal WIC participation on birth outcomes, including associated
                                                                                         health care costs—Continued
                                                                                                                                                                            Population                                   Measure of
                                                                                                                                                            1                           2
                                                                                         Study                         Outcome(s)              Data source                (sample size)             Design               participation               Analysis method

                                                                                         Stockbauer             Birthweight,             Linked WIC, birth, and        WIC and non-WIC         Participants vs.     Participation dummy         Analysis of covariance.
                                                                                         (1986)                 gestational age,         death record files for        Missouri residents      3 different          and dose-response:          Separate analyses for
                                                                                                                likelihood of low        1980 births in Missouri       with singleton births   nonparticipant       Duration of participation   White, non-White, and
                                                                                                                birthweight, and                                       (n=6,732 WIC;           groups:              and dollar value of         total group.
                                                                                                                neonatal mortality                                     sample for non-         (1) all non-WIC      redeemed WIC
                                                                                                                rate                                                   WIC not reported)       births; (2) random   coupons
                                                                                                                                                                                               sample of non-
                                                                                                                                                                                               WIC births;
                                                                                                                                                                                               (3) matched
                                                                                                                                                                                               group of non-
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                                                                             14
                                                                                                                                                                                               WIC births
                                                                                         Schramm (1985)         Birthweight,             Linked WIC, Medicaid,         WIC and non-WIC         Participant vs.      Participation dummy         Analysis of covariance
                                                                                                                likelihood of low        birth, and hospital care      Medicaid recipients     nonparticipant       and dose response:
                                                                                                                birthweight,             records for 1980 births       (n=7,628)                                    WIC food costs
                                                                                                                Medicaid costs           in Missouri                                                                adjusted for length
                                                                                                                                                                                                                    of pregnancy
                                                                                         Kotelchuck,            Birthweight, gesta-      Linked WIC, birth,            Matched WIC and         Participant vs.      Participation dummy         Bivariate comparisons
                                                                                         et al. (1984)          tional age, likelihood   and death records             non-WIC women           matched control      and dose response:
                                                                                                                of low birthweight,      for 1978 births in            with singleton births                        Months on WIC and
                                                                                                                                                                                       15
                                                                                                                premature birth,         Massachusetts                 (n=4,126 pairs)                              percent of pregnancy
                                                                                                                small-for-gestational-                                                                              on WIC
                                                                                                                age birth, and neo-
                                                                                                                natal mortality rate
                                                                                         Group IV: Other State and local studies
                                                                                         Reichman and           Birthweight,             Standardized data             All WIC and non-        Participant vs.      Participation dummy         Multivariate regression,
                                                                                         Teitler (2003)         likelihood of low        collected for women           WIC HealthStart         nonparticipant                                   including attempt to control
                                                                                                                                                                                                                                                                 16
                                                                                                                birthweight              enrolled in New Jersey’s      participants who                                                         for simultaneity
                                                                                                                                         HealthStart program for       had a live singleton
                                                                                                                                         pregnant Medicaid             birth (n=90,117)
                                                                                                                                         recipients between 1988
                                                                                                                                         and 1996
                                                                                         Brown et al.           Birthweight,             Medical records, birth, and   Non-Hispanic            Participant vs.      Participation dummy         Multivariate regression
                                                                                         (1996)                 likelihood of low        death certificates for        women who deliv-        nonparticipant
                                                                                                                birthweight, and         births in 1 Indiana hospi-    ered at the area’s
                                                                                                                infant mortality rate    tal between January           primary hospital for
                                                                                                                                         1988 and June 1989            the “underserved”
                                                                                                                                                                       (n=4,707)
                                                                                          See notes at end of table.                                                                                                                                            Continued—
67
68

                                                                                         Appendix table 5—Studies that examined the impact of prenatal WIC participation on birth outcomes, including associated
                                                                                         health care costs—Continued
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                                    Population                                Measure of
                                                                                                                                                        1                       2
                                                                                         Study                          Outcome(s)         Data source            (sample size)             Design            participation          Analysis method
                                                                                         Mays-Scott              Birthweight         WIC records in 1 county    Prenatal WIC           Participants,     Dose response:         Analysis of variance
                                                                                         (1991)                                      health department in       participants who       before            Number of months
                                                                                                                                     Texas (1987-89)            were <17 years and     vs. after         enrolled, nutrition
                                                                                                                                                                had at least 1                           education contacts,
                                                                                                                                                                previous pregnancy                       and voucher pickups
                                                                                                                                                                (n=217)
                                                                                         Collins et al.          Birthweight         Primary data collection    WIC and non-WIC        Participant vs.   Participation dummy    Bivariate t-tests
                                                                                         (1985)                                      in public health           pregnant women         nonparticipant
                                                                                                                                     department clinics in 6    (n=519)
                                                                                                                                     Alabama counties
                                                                                                                                     (1980-81)
                                                                                         Metcoff et al.          Birthweight         Primary data               Income-eligible        Randomized        Participation dummy    Multivariate regression
                                                                                         (1985)                                      collection at a prenatal   pregnant women         experiment
                                                                                                                                     clinic in 1 hospital in    selected at mid-
                                                                                                                                     Oklahoma (1983-84)         pregnancy based
                                                                                                                                                                on predicted
                                                                                                                                                                birthweight; roughly
                                                                                                                                                                equivalent numbers
                                                                                                                                                                were predicted to
                                                                                                                                                                have average-size
                                                                                                                                                                babies vs. small or
                                                                                                                                                                large babies
                                                                                                                                                                (n=410)
                                                                                         Heimendinger et         Birthweight         WIC and medical            WIC and Medicaid-      Participant vs.   Participation dummy    Multivariate regression
                                                                                         al. (1984)                                  records in 3 WIC clinics   eligible infants and   nonparticipant    based on mother’s
                                                                                                                                     and 4 non-WIC clinics in   toddlers up to 20                        participation in WIC
                                                                                                                                     the same Boston            months of age with                       during pregnancy
                                                                                                                                     neighborhoods              at least 2 height
                                                                                                                                     (1979-81)                  and weight
Economic Research Service/USDA




                                                                                                                                                                                 17
                                                                                                                                                                measurements
                                                                                                                                                                (n=1,907)
                                                                                           See notes at end of table.                                                                                                                           Continued—
Economic Research Service/USDA

                                                                                         Appendix table 5—Studies that examined the impact of prenatal WIC participation on birth outcomes, including associated
                                                                                         health care costs—Continued
                                                                                                                                                                      Population                                Measure of
                                                                                                                                                       1                          2
                                                                                         Study                          Outcome(s)         Data source              (sample size)            Design             participation        Analysis method

                                                                                         Kennedy and             Birthweight,        WIC and medical             Matched WIC and        Participant vs.   Participation dummy   Bivariate comparisons
                                                                                         Kotelchuck (1984)       gestational age,    records in WIC sites and    non-WIC pairs of       matched control   and dose response:
                                                                                                                 likelihood of low   non-WIC health facilities   pregnant women                           Number of months
                                                                                                                                                                               18, 19
                                                                                                                 birthweight and     in 4 geographic areas of    (n=418 pairs)                            vouchers received
                                                                                                                 small-for-          Massachusetts
                                                                                                                 gestational-age     (1973-78)
                                                                                                                 birth, and fetal    (Reanalysis of data from
                                                                                                                 death rate          Kennedy et al., 1982)
                                                                                         Bailey et al.           Birthweight         Primary data collection     WIC and income-        Participant vs.   Participation dummy   Multivariate regression
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                         (1983)                                      at 1 WIC site and 1 non-    eligible nonpartici-   nonparticipant
                                                                                                                                     WIC site in Florida         pants who were 30
                                                                                                                                     (Dates not reported)        weeks pregnant at
                                                                                                                                                                 time of recruitment
                                                                                                                                                                 and receiving
                                                                                                                                                                 identical prenatal
                                                                                                                                                                 care (n=101)
                                                                                         Paige (1983)            Medicaid costs,     Medicaid records in 4       WIC and income-        Participant vs.   N/A                   Comparisons of means
                                                                                                                 health care         counties in Maryland, 2     eligible non-WIC       nonparticipant                          and proportions (no
                                                                                                                 utilization         in which WIC was            women who were                                                 statistical tests reported)
                                                                                                                                     available and 2 in which    on Medicaid for at
                                                                                                                                     WIC was not available       least 16 weeks
                                                                                                                                     (1979-80)                   during pregnancy
                                                                                                                                                                 (n=114)
                                                                                         Kennedy,                Birthweight,        WIC and medical             WIC and WIC-           Participant vs.   Participation dummy   Multivariate regression
                                                                                         et al. (1982)           likelihood of low   records in WIC              eligible women         nonparticipant    and dose response:
                                                                                                                                                                           18
                                                                                                                 birthweight         sites and non-WIC           (n=1,297)                                Number of vouchers
                                                                                                                                     health facilities in                                                 received, months
                                                                                                                                     4 geographic areas                                                   on WIC
                                                                                                                                     of Massachusetts
                                                                                                                                     (1973-78)
                                                                                           See notes at end of table.                                                                                                                            Continued—
69
70

                                                                                         Appendix table 5—Studies that examined the impact of prenatal WIC participation on birth outcomes, including associated
                                                                                         health care costs—Continued
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                                                  Population                                         Measure of
                                                                                                                                                                 1                            2
                                                                                         Study                         Outcome(s)                  Data source                  (sample size)                Design                  participation                Analysis method
                                                                                         Silverman (1982)         Birthweight,              Medical records for             WIC and income-            Participants,          Participation dummy            Multivariate regression
                                                                                                                  likelihood of low         random sample of                eligible                   before vs. after,
                                                                                                                  birthweight               women enrolled in               nonparticipants            separate groups
                                                                                                                                            Maternity and Infant            (n=2,514)
                                                                                                                                            Care Project (MIC) in
                                                                                                                                            Allegheny County, PA,
                                                                                                                                            before (1971-74) and
                                                                                                                                            after (1974-77) initiation
                                                                                                                                            of WIC
                                                                                           Notes: N/A = Not applicable.
                                                                                           1
                                                                                             Data sources:
                                                                                                 FNS WIC/Medicaid = FNS’ WIC/Medicaid database.
                                                                                                 NLSY = National Longitudinal Survey of Youth.
                                                                                                 NMIHS = National Maternal and Infant Health Survey.
                                                                                           2
                                                                                             Unless the description of the study sample indicates that a comparison group was limited to nonparticipants who were income-eligible for WIC or known to be Medicaid participants, all
                                                                                         income levels were included in the comparison group. Income was generally controlled for in the analysis if the information was available.
                                                                                           3
                                                                                             Maximum analysis sample; sample varies by outcome. Birth outcome data were available for only about 75 percent of women in the study.
                                                                                           4
                                                                                             Intrauterine growth retardation defined as fetal growth ratio of less than 85 percent (observed birthweight at gestational age by mean for gestational age of sex-specific fetal growth
                                                                                         distribution). Heavy preemie defined as birthweight of 2,500 gm or more and gestation of less than 37 weeks. (Authors report that mortality rate for heavy preemies may be twice that of
                                                                                         normal birthweight infants).
                                                                                           5
                                                                                             Used three alternative definitions of WIC participation to control for simultaneity in analyses of impacts on birthweight and gestational age: (1) during first 8 months; (2) during first 7
                                                                                         months; (3) during first 6 months. Also estimated model for birthweight that controlled for gestational age.
                                                                                           6
                                                                                             For all outcomes, estimated basic model as well as separate models for four different cohorts defined by length of gestation thresholds: 28 weeks, 32 weeks, 36 weeks, and 40 weeks.
                                                                                           7
                                                                                             Authors also examined impacts on birth defects, C-section, and complications during pregnancy and delivery. No significant differences were noted for birth defects or complications during
                                                                                         pregnancy and delivery. The rate of C-section was significantly greater for WIC participants.
                                                                                           8
                                                                                             Alternative models included (1) women who enrolled in WIC after 33 weeks gestation included in the nonparticipant group, (2) three separate cohorts, based on gestational age (29, 33,
                                                                                         and 37 weeks), and (3) gestational age as a control variable.
                                                                                           9
                                                                                             Exposure for women who did participate in WIC was considered high = enrolled before 12 weeks gestation, medium = enrolled at 12-20 weeks gestation, and low = enrolled at 21-37
                                                                                         weeks gestation.
                                                                                           10
                                                                                              In addition to basic model, estimated alternative model that included women who enrolled in WIC at 36 weeks gestation or later in the nonparticipant group.
Economic Research Service/USDA




                                                                                           11
                                                                                              Alternative models defined WIC participants as those who enrolled in WIC (1) before 32 weeks gestation and (2) by 30 weeks gestation.
                                                                                           12
                                                                                              Estimated two alternative models: (1) basic model with addition of control for first-trimester WIC participation and gestational age, (2) basic model with WIC participants who enrolled after
                                                                                         36 weeks considered nonparticipants.
                                                                                           13
                                                                                              Pairs matched on age, race, education, gravidity, number of births this pregnancy, and marital status.
                                                                                           14
                                                                                              Pairs matched on age, race, education, number births this pregnancy, smoking during pregnancy, and pre-pregnancy weight.
                                                                                           15
                                                                                              Pairs matched within catchment area on age, race, parity, education, and marital status.
                                                                                           16                                                                                                                                st    nd
                                                                                              Included separate model to control for gestational-age bias, but sample was restricted based on initiation of prenatal care (1 or 2 trimester) rather than timing of WIC enrollment.
                                                                                           17
                                                                                              The main focus of study was impact of WIC on children’s growth; however, the authors compared birthweights of subjects whose mothers were and were not in WIC.
                                                                                           18
                                                                                              WIC-eligible women included in the nonparticipant group were wait-listed for WIC during their pregnancy, enrolled in WIC postpartum, or women who received prenatal care at non-WIC
                                                                                         health care facilities in same neighborhood but never enrolled in WIC.
                                                                                           19
                                                                                               Approximately 80 percent of women were matched on race, age, parity, marital status, and income. The remainder were matched on four of the five variables.
Economic Research Service/USDA

                                                                                         Appendix table 6—Studies that examined the impact of the WIC program on breastfeeding
                                                                                                                                                                   Population                                Measure of
                                                                                                                                                      1                        2
                                                                                         Study                          Outcome(s)        Data source            (sample size)             Design            participation          Analysis method

                                                                                         Group I: National evaluations
                                                                                         Rush et al.             Breastfeeding       Primary data collection   Random sample of       Participant vs.   Participation dummy    Multivariate regression
                                                                                         (1988c) (NWE)           initiation and      in 174 WIC sites and 55   infants and children   nonparticipant    based on age of
                                                                                                                 duration            prenatal clinics          of women included                        inception into WIC,
                                                                                                                                     (1983-84)                 in the longitudinal                      including prenatally
                                                                                                                                                               study of women
                                                                                                                                                               (see Rush et al.,
                                                                                                                                                               1988d below)
                                                                                                                                                               (n=2,370)
                                                                                         Rush et al.             Breastfeeding       Primary data collection   Nationally             Participant vs.   Participation dummy    Multivariate regression
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                         (1988d) (NWE)           intention and       in 174 WIC sites and 55   representative         nonparticipant
                                                                                                                 initiation          prenatal clinics          sample of pregnant
                                                                                                                                     (1983-84)                 WIC participants
                                                                                                                                                               and comparison
                                                                                                                                                               group receiving
                                                                                                                                                               prenatal care in
                                                                                                                                                               surrounding public
                                                                                                                                                               health clinics or
                                                                                                                                                               hospitals (n=3,935)
                                                                                         Group II: Secondary analysis of national surveys
                                                                                         Chatterji et al.        Breastfeeding       1989-95 NLSY              (1) NLSY children      Participant vs.   Participation dummy    (1) (2) Multivariate
                                                                                         (2002)                  initiation and                                born between 1990      nonparticipant                           regression, including
                                                                                                                 duration                                      and 1995 (n=1,282)                                              attempt to control for
                                                                                                                                                               (2) Low-income                                                  selection bias
                                                                                                                                                               NLSY children born                                              (3) Fixed-effects model
                                                                                                                                                               between 1991 and
                                                                                                                                                               1995 (n=517)
                                                                                                                                                               (3) NLSY children
                                                                                                                                                               born between 1989
                                                                                                                                                               and 1995, with at
                                                                                                                                                               least one other
                                                                                                                                                               sibling born during
                                                                                                                                                               the same period
                                                                                                                                                               (n=970)
                                                                                           See notes at end of table.                                                                                                                         Continued—
71
                                                                                         Appendix table 6—Studies that examined the impact of the WIC program on breastfeeding—Continued
72



                                                                                                                                                                  Population                                   Measure of
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                      1                       2
                                                                                         Study                         Outcome(s)        Data source            (sample size)              Design              participation             Analysis method

                                                                                         Balcazar et al.        Breastfeeding       1988 NMIHS live births    Mexican-American        Participant vs.     Participation dummy       Multivariate regression
                                                                                         (1995)                 intention                                     and non-Hispanic        nonparticipant
                                                                                                                                                              White women who
                                                                                                                                                              were not undecided
                                                                                                                                                              about infant feeding
                                                                                                                                                              plans prior to the
                                                                                                                                                              infant’s birth
                                                                                                                                                              (n=4,089)
                                                                                         GAO (1993)             Breastfeeding       1989-92 RLMS              Nationally              Prenatal            Participation dummy       Multivariate regression
                                                                                                                initiation                                    representative          participants vs.
                                                                                                                                                              sample of mothers       nonparticipants
                                                                                                                                                              of 6-month-old          and postpartum-
                                                                                                                                                              babies. Analysis        only participants
                                                                                                                                                              included all
                                                                                                                                                              respondents with
                                                                                                                                                              complete data for
                                                                                                                                                              questions of
                                                                                                                                                                                  3
                                                                                                                                                              interest (n=79,428)
                                                                                         Schwartz et al.        Breastfeeding       1988 NMIHS                WIC participants        Participants who    Participation dummy       3-stage regression with
                                                                                         (1992)                 initiation and                                and income-eligible     received advice     and advice dummy          selection-bias adjustment
                                                                                                                duration                                      nonparticipants         to breastfeed
                                                                                                                                                              (n=6,170)               compared with
                                                                                                                                                                                      participants who
                                                                                                                                                                                      did not receive
                                                                                                                                                                                      advice and to
                                                                                                                                                                                      income-eligible
                                                                                                                                                                                      nonparticipants
                                                                                         Ryan et al. (1991)     Breastfeeding       1984 and 1989 RLMS        Respondents in          Participant vs.     Participation dummy       Multivariate regression
                                                                                                                initiation and                                1984 and 1989           nonparticipant
Economic Research Service/USDA




                                                                                                                duration                                      (n=120,334)
                                                                                         Group III: State and local studies
                                                                                         Tuttle and Dewey       Breastfeeding       Primary data collection   Hmong and               Participant vs.     Dose response:            Multivariate regression
                                                                                         (1994)                 initiation          in WIC clinics and        Vietnamese WIC          nonparticipant      Number of times
                                                                                                                                    neighborhoods in          participants whose                          previously participated
                                                                                                                                    1 northern California     youngest child was                          in WIC
                                                                                                                                    community                 less than 1 year
                                                                                                                                                              (n=122)
                                                                                          See notes at end of table.                                                                                                                               Continued—
Economic Research Service/USDA

                                                                                         Appendix table 6—Studies that examined the impact of the WIC program on breastfeeding—Continued
                                                                                                                                                                                Population                                        Measure of
                                                                                                                                                                1                           2
                                                                                         Study                        Outcome(s)                  Data source                 (sample size)               Design                  participation                Analysis method

                                                                                         Burstein et al.         Breastfeeding             Primary data collection         Random sample             Participant vs.       Participation dummy           Multivariate regression,
                                                                                         (1991)                  initiation and            in Florida and North            of WIC and                nonparticipant                                      including attempt to
                                                                                                                 duration                  Carolina (1990-91)              income-eligible                                                               control for selection bias
                                                                                                                                                                           infants (6 months
                                                                                                                                                                           old) stratified by
                                                                                                                                                                           birthweight (n=807)
                                                                                           1
                                                                                             Data sources:
                                                                                                 NLSY = National Longitudinal Survey of Youth.
                                                                                                 NMIHS = National Maternal and Infant Health Survey.
                                                                                                 RLMS = Ross Laboratories Mother’s Survey.
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                           2
                                                                                             Unless the description of the study sample indicates that a comparison group was limited to nonparticipants who were income eligible for WIC or known to be Medicaid participants, all
                                                                                         income levels were included in the comparison group.
                                                                                           3
                                                                                             Overall response rate for survey was approximately 50 percent. After excluding cases with incomplete data, analysis sample comprised only 34 percent of the initial survey sample.
73
                                                                                         Appendix table 7—Studies that examined the impact of the WIC program on nutrition and health outcomes of pregnant women
74



                                                                                                                                                                   Population                                 Measure of
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                      1                        2
                                                                                         Study                         Outcome(s)        Data source             (sample size)            Design              participation            Analysis method

                                                                                         Group I: National evaluations
                                                                                         Rush et al.            Dietary intake,     Primary data collection    Nationally            Participant vs.     Participation dummy      Multivariate regression
                                                                                         (1988d) (NWE)          prevalence of       and record abstractions    representative        nonparticipant
                                                                                                                anemia,             in 174 WIC sites and 55    sample of pregnant
                                                                                                                pregnancy weight    prenatal clinics           WIC participants
                                                                                                                gain                (1983-84). Data were       and comparison
                                                                                                                                    collected at time of       group receiving
                                                                                                                                    enrollment into WIC or     prenatal care in
                                                                                                                                    prenatal care and again    surrounding public
                                                                                                                                    at about 8 months          health clinics or
                                                                                                                                    gestation                  hospitals (n=3,473)
                                                                                         Edozien et al.         Dietary intake,     Primary data collection    Pregnant women        (1) Nutritional     Dose response: Newly     Multivariate regression
                                                                                         (1979)                 hemoglobin,         in 19 sites in 14 States   who enrolled in       biochemistries:     enrolling participants
                                                                                                                                                                              3
                                                                                                                prevalence of       (1973-76). Data were       WIC (n~2,885)         Participants,       vs. participants with
                                                                                                                anemia, pregnancy   collected at time of WIC                         before vs. after,   varying length of
                                                                                                                weight gain         enrollment, approxi-                             separate groups     participation
                                                                                                                                    mately every 3 months                            (2) Dietary
                                                                                                                                    until delivery, and once                         intake:
                                                                                                                                    after delivery                                   Participants,
                                                                                                                                                                                     before vs. after,
                                                                                                                                                                                     same women
                                                                                         Group II: Secondary analysis of national survey data
                                                                                         Mardis and             Dietary intake      1988-94 NHANES-III         WIC and income-       Participant vs.     Participation dummy      Bivariate t-tests
                                                                                         Anand (2000)                                                          eligible women        nonparticipant
                                                                                                                                                               (n=242)
                                                                                         Kramer-LeBlanc         Dietary intake      1988-94 NHANES-III         WIC and income-       Participant vs.     Participation dummy      Bivariate t-tests
                                                                                         et al. (1999)                                                         eligible women        nonparticipant
                                                                                                                                                               (n=242)
Economic Research Service/USDA




                                                                                          See notes at end of table.                                                                                                                                  Continued—
                                                                                         Appendix table 7—Studies that examined the impact of the WIC program on nutrition and health outcomes of pregnant women—Continued
Economic Research Service/USDA



                                                                                                                                                                          Population                                Measure of
                                                                                                                                                             1                        2
                                                                                         Study                          Outcome(s)              Data source             (sample size)             Design            participation         Analysis method
                                                                                         Group III: State-level studies using WIC participation files matched with Medicaid and/or birth record files
                                                                                         Roth et al. (2004)      Pregnancy weight         Linked WIC, Medicaid,       WIC and non-WIC        Participant vs.   Participation dummy   Multivariate regression
                                                                                                                 gain                     and vital statistics        Medicaid recipients    nonparticipant
                                                                                                                                          records for births in       who did not
                                                                                                                                          Florida between January     participate in high-
                                                                                                                                          1996 and the end of         risk obstetrical
                                                                                                                                          December 2000               program
                                                                                                                                                                      (n=295,599)
                                                                                         Group IV: Other State and local studies
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                         Collins et al.          Pregnancy weight         Primary data collection     WIC and non-WIC        Participant vs.   Participation dummy   Bivariate t-tests
                                                                                         (1985)                  gain                     in public health            pregnant women         nonparticipant
                                                                                                                                          department clinics in 6     (n=519)
                                                                                                                                          Alabama counties
                                                                                                                                          (1980-81)
                                                                                         Metcoff et al.          Variety of nutritional   Primary data collection     Income-eligible        Randomized        Participation dummy   Multivariate regression
                                                                                         (1985)                  biochemistries           at a prenatal clinic in 1   pregnant women         experiment
                                                                                                                                          hospital in Oklahoma        selected at mid-
                                                                                                                                          (1983-84)                   pregnancy based
                                                                                                                                                                      on predicted
                                                                                                                                                                      birthweight; roughly
                                                                                                                                                                      equivalent numbers
                                                                                                                                                                      were predicted to
                                                                                                                                                                      have average-size
                                                                                                                                                                      babies vs. small or
                                                                                                                                                                      large babies
                                                                                                                                                                      (n=410)
                                                                                         Bailey et al.           Dietary intake,          Primary data collection     WIC and income-        Participant vs.   Participation dummy   Analysis of variance
                                                                                         (1983)                  nutritional              at 1 WIC site and 1         eligible nonparti-     nonparticipant
                                                                                                                 biochemistries           non-WIC site in Florida     cipants were 30
                                                                                                                                          (Dates not reported)        weeks pregnant at
                                                                                                                                                                      time of recruitment
                                                                                                                                                                      and receiving
                                                                                                                                                                      identical prenatal
                                                                                                                                                                      care (n=101)
                                                                                           See notes at end of table.                                                                                                                                    Continued—
75
76

                                                                                         Appendix table 7—Studies that examined the impact of the WIC program on nutrition and health outcomes of pregnant women—Continued
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4



                                                                                                                                                                                 Population                                        Measure of
                                                                                                                                                                 1                           2
                                                                                         Study                        Outcome(s)                   Data source                 (sample size)                Design                 participation                 Analysis method

                                                                                         Kennedy and             Hemoglobin and             WIC and medical                 WIC and WIC-              Participants vs.       Dose response:                Multivariate regression
                                                                                                                                                                                           4
                                                                                         Gershoff (1982)         hematocrit levels          records in WIC sites and        eligible women            nonparticipants,       Number of WIC
                                                                                                                                            non-WIC health facilities       (n=232)                   before and after       vouchers received
                                                                                                                                            in 4 geographic areas of
                                                                                                                                            Massachusetts
                                                                                                                                            (1973-78)
                                                                                         Endres et al.           Dietary intake             Dietary recalls for             Newly enrolling           Participants,          Participation dummy           Bivariate t-tests
                                                                                         (1981)                                             sample of pregnant WIC          pregnant WIC              before vs. after,
                                                                                                                                            participants in 22              participants and          separate groups
                                                                                                                                            counties in Illinois            participants who
                                                                                                                                            (1978-79)                       were on the
                                                                                                                                                                            program for 6
                                                                                                                                                                            months or
                                                                                                                                                                            more (n=766)
                                                                                           1
                                                                                             Data source: NHANES = National Health and Nutrition Examination Survey.
                                                                                           2
                                                                                             Unless the description of the study sample indicates that a comparison group was limited to nonparticipants who were income eligible for WIC or known to be Medicaid participants, all
                                                                                         income levels were included in the comparison group.
                                                                                           3
                                                                                             Approximate maximum; sample size varied for each measure and analysis approach.
                                                                                           4
                                                                                             Subset of participants in larger study focusing on impact of WIC on birthweight (see table 5). WIC-eligible women included in the nonparticipant group were wait-listed for WIC during their
                                                                                         pregnancy, enrolled in WIC postpartum, or were women who received prenatal care at non-WIC health care facilities in same neighborhood but never enrolled in WIC.
Economic Research Service/USDA
Economic Research Service/USDA

                                                                                         Appendix table 8—Studies that examined the impact of the WIC program on nutrition and health outcomes of infants and children
                                                                                                                                                                       Population                                  Measure of
                                                                                                                                                         1                         2
                                                                                         Study                         Outcome(s)            Data source             (sample size)             Design              participation         Analysis method

                                                                                         Group I: National evaluations
                                                                                         Rush et al.            Dietary intake,        Primary data collection     Random sample of       Participant vs.    Participation dummy    Multivariate regression
                                                                                         (1988c) (NWE)          weight, height, head   in 174 WIC sites and 55     infants and children   nonparticipant     based on age of
                                                                                                                circumference, arm     prenatal clinics (1983)     ages 0-4 of women                         inception into WIC,
                                                                                                                circumference and                                  included in the                           including prenatally
                                                                                                                skinfold thickness,                                longitudinal study
                                                                                                                immunization                                       of women (see
                                                                                                                status, use of                                     Rush et al. (1988d)
                                                                                                                preventive health                                  in table 17)
                                                                                                                care, behavior,                                    (n=2,370)
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                vocabulary, and
                                                                                                                memory
                                                                                         Edozien et al.         Dietary intake,        Primary data collection     WIC infants and        Participants,      Participation dummy    Multivariate regression
                                                                                         (1979)                 blood iron             in 19 WIC sites in 14       children ages 6-47     before vs. after
                                                                                                                                                                               3
                                                                                                                measures, height,      States. Data collected at   (n=16,000+)
                                                                                                                weight, and head       time of WIC enrollment
                                                                                                                circumference          and again after 6 and 11
                                                                                                                                       months of participation
                                                                                                                                       (1973-76)
                                                                                         Group II: Secondary analysis of national surveys
                                                                                         Cole and Fox           Dietary intake,        1988-94 NHANES-III,         WIC and income-        Participant vs.    Participation dummy    Bivariate t-tests
                                                                                         (2004)                 infant feeding         usual intake                eligible children      nonparticipant
                                                                                                                practices, height,                                 ages 1-4 (n=3,006)
                                                                                                                weight, variety of
                                                                                                                nutritional
                                                                                                                biochemistries,
                                                                                                                general health
                                                                                                                status, and dental
                                                                                                                health
                                                                                         Ponza et al.           Dietary intake         2002 FITS, usual intake     WIC and non-WIC        Participant vs.    N/A                    Comparison of means and
                                                                                         (2004)                                                                    infants and children   nonparticipant                            proportions (no statistical
                                                                                                                                                                   ages 2-24 months                                                 tests reported)
                                                                                                                                                                   (n=3,022)
                                                                                          See notes at end of table.                                                                                                                                    Continued—
77
                                                                                         Appendix table 8—Studies that examined the impact of the WIC program on nutrition and health outcomes of infants and children—Continued
78



                                                                                                                                                                   Population                               Measure of
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                      1                        2
                                                                                         Study                         Outcome(s)          Data source           (sample size)            Design            participation               Analysis method

                                                                                         Siega-Riz et al.       Dietary intake        1994-96 and 1998 CSFII   WIC- and income-      Participant vs.   Participation dummy         Multivariate regression;
                                                                                         (2004)                                                                eligible children     nonparticipant                                investigated but did not
                                                                                                                                                               ages 2-5 who were                                                   implement correction for
                                                                                                                                                               not enrolled in                                                     selection bias
                                                                                                                                                               school, in 2 income
                                                                                                                                                               groups: <130% of
                                                                                                                                                               poverty (n=1,772)
                                                                                                                                                               and 130-185% of
                                                                                                                                                               poverty (n=689)
                                                                                         Luman et al.           Immunization status   2000-01 NIS              WIC and non-WIC       Participant vs.   Participation dummy,        Multivariate regression
                                                                                         (2003)                                                                children ages         nonparticipant    with non-WIC children
                                                                                                                                                               19-35 months                            divided by income
                                                                                                                                                               (n=21,212)                              eligibility and prior WIC
                                                                                                                                                                                                       participation:
                                                                                                                                                                                                       Ineligible, eligible and
                                                                                                                                                                                                       participated in the past,
                                                                                                                                                                                                       and eligible but never
                                                                                                                                                                                                       participated
                                                                                                                                                                                                                                                       4
                                                                                         Shefer et al.          Immunization status   1999 NIS                 WIC and non-WIC       Participant vs.   Participation dummy,        Bivariate t-tests
                                                                                         (2001)                                                                children ages         nonparticipant    with non-WIC children
                                                                                                                                                               24-35 months                            divided by income and
                                                                                                                                                               (n=15,500)                              prior WIC participation:
                                                                                                                                                                                                       previously on WIC,
                                                                                                                                                                                                       never on WIC and
                                                                                                                                                                                                       income-eligible, and
                                                                                                                                                                                                       never on WIC and not
                                                                                                                                                                                                       income-eligible
                                                                                         Carlson and            Physician-reported    1988-94 NHANES-III       Children ages         Participant vs.   Participation dummy         Ordered probit equations
                                                                                         Senauer (2003)         general health                                 24-60 months          nonparticipant
Economic Research Service/USDA




                                                                                                                status                                         (1) WIC sample:
                                                                                                                                                               WIC and income-
                                                                                                                                                               eligible
                                                                                                                                                               (2) Full sample:
                                                                                                                                                               WIC and non-WIC
                                                                                          See notes at end of table.                                                                                                                                   Continued—
Economic Research Service/USDA

                                                                                         Appendix table 8—Studies that examined the impact of the WIC program on nutrition and health outcomes of infants and children—Continued
                                                                                                                                                                      Population                                Measure of
                                                                                                                                                        1                         2
                                                                                         Study                         Outcome(s)            Data source            (sample size)             Design            participation         Analysis method

                                                                                         Kranz and Siega-       Added sugar intake      1994-96 CSFII            WIC and income-         Participant vs.   Participation dummy   Multivariate regression
                                                                                         Riz (2002)                                                              eligible children       nonparticipant
                                                                                                                                                                 ages 2-5 (n=5,652)
                                                                                         Variyam (2002)         Dietary intake          1994-96 and 1998 CSFII   WIC and income-         Participant vs.   Participation dummy   Multivariate regression;
                                                                                                                                                                 eligible children       nonparticipant                          quantile regressions
                                                                                                                                                                 ages 1-4 (n=2,509)
                                                                                         Burstein et al.        Dietary intake,         1988-94 NHANES-III       WIC and income-         Participant vs.   Participation dummy   Bivariate t-tests
                                                                                         (2000)                 height, weight,         1993-95 SIPP             eligible children       nonparticipant
                                                                                                                nutritional             1995-97 CCDP
                                                                                                                                                                 NHANES-III = 2,979
                                                                                                                biochemistries,
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                                 (12-59 months)
                                                                                                                immunization
                                                                                                                status, general                                  SIPP = 1,302
                                                                                                                health status, dental                            (1-4 years)
                                                                                                                health, use of
                                                                                                                preventive health                                CCDP = 2,067
                                                                                                                care, and physical,                              (2 years)
                                                                                                                emotional, and
                                                                                                                cognitive
                                                                                                                development
                                                                                         Kowaleski-Jones        Motor skills, social    NLSY, 1990-96 waves      (1) WIC and non-        Participant vs.   Participation dummy   (1) Multivariate regression
                                                                                         and Duncan             skills, and                                      WIC infants and         nonparticipant                          (2) Fixed-effects model
                                                                                                                                                                                   5
                                                                                         (2000)                 temperament                                      children (n=1,984)
                                                                                                                                                                 (2) WIC and non-
                                                                                                                                                                 WIC infants and
                                                                                                                                                                 children with at
                                                                                                                                                                 least 1 other sibling
                                                                                                                                                                 born during the
                                                                                                                                                                 same period
                                                                                                                                                                 (n=453 sibling
                                                                                                                                                                        5
                                                                                                                                                                 pairs)
                                                                                          See notes at end of table.                                                                                                                                 Continued—
79
80

                                                                                         Appendix table 8—Studies that examined the impact of the WIC program on nutrition and health outcomes of infants and children—Continued
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4



                                                                                                                                                               Population                               Measure of
                                                                                                                                                     1                     2
                                                                                         Study                         Outcome(s)         Data source        (sample size)            Design            participation            Analysis method
                                                                                                                                                                                                                                                      6
                                                                                         Oliveira and           Dietary intake       1994-96 CSFII        WIC and income-        Participant vs.   Participation dummy      Multivariate regression
                                                                                         Gundersen                                                        eligible children      nonparticipant
                                                                                         (2000)                                                           ages 1-4 in
                                                                                                                                                          households where
                                                                                                                                                          at least 1 other
                                                                                                                                                          person also
                                                                                                                                                          participated in WIC
                                                                                                                                                          (n=180)
                                                                                         Kramer-LeBlanc         Dietary intake       1988-94 NHANES-III   WIC and income-        Participant vs.   Participation dummy      Bivariate t-tests
                                                                                         et al. (1999)                                                    eligible infants and   nonparticipant
                                                                                                                                                          children ages 2
                                                                                                                                                          months-4 years
                                                                                                                                                          (n=6,636)
                                                                                         Rose et al. (1998)     Dietary intake       1989-91 CSFII        WIC and non-WIC        Participant vs.   Dose response:           Multivariate regression;
                                                                                                                                                          children ages 1-4      nonparticipant    Value of monthly         investigated but did not
                                                                                                                                                          who were not                             household per capita     implement adjustment for
                                                                                                                                                          breastfeeding and                        WIC benefit              selection bias
                                                                                                                                                          resided in FSP-
                                                                                                                                                          eligible households
                                                                                                                                                          (n=499)
                                                                                         Centers for            Dietary intake,      1988-91 NHANES-III   WIC and income-        Participant vs.   Participation dummy      Multivariate regression
                                                                                         Disease Control        height, and weight                        eligible infants and   nonparticipant                             (height and weight)
                                                                                         (1995)                                                           children ages 2-59
                                                                                                                                                                                                                            Comparison of means
                                                                                                                                                          months (n=3,488 )
                                                                                                                                                                                                                            (dietary intake)
                                                                                         Rose et al. (1995)     Iron intake          1989-91 CSFII        WIC and non-WIC        Participant vs.   Participation dummy      Multivariate regression
                                                                                                                                                          children ages 1-4      nonparticipant
                                                                                                                                                          who were not
                                                                                                                                                          breastfeeding
Economic Research Service/USDA




                                                                                                                                                          (n=800)
                                                                                         Fraker et al.          Dietary intake       1985 CSFII           WIC and income-        Participant vs.   Dose response:           Multivariate regression
                                                                                         (1990)                                                           eligible children      nonparticipant    Proportion of 4 recall   with selection-bias
                                                                                                                                                          ages 1-4 (n=445)                         days on which child      adjustment
                                                                                                                                                                                                   was enrolled in WIC;
                                                                                                                                                                                                   also tested for
                                                                                                                                                                                                   combined WIC and
                                                                                                                                                                                                   FSP participation
                                                                                          See notes at end of table.                                                                                                                            Continued—
                                                                                         Appendix table 8—Studies that examined the impact of the WIC program on nutrition and health outcomes of infants and children—Continued
Economic Research Service/USDA



                                                                                                                                                                         Population                                Measure of
                                                                                                                                                           1                         2
                                                                                         Study                         Outcome(s)             Data source              (sample size)             Design            participation              Analysis method

                                                                                         Group III: Secondary analysis of State-level files
                                                                                         Lee et al. (2004a)     Number of dental        Longitudinal linked data     WIC and non-WIC        Participant vs.   Dose-response:             Multivariate regression
                                                                                                                visits per year and     base, including birth,       Medicaid recipients    nonparticipant    Number of months any       and ordered probit
                                                                                                                use of dental           Medicaid, WIC, and           ages 1-4                                 WIC vouchers               analysis, including 2-stage
                                                                                                                services                Area Resource files for      (n=49,795)                               redeemed                   modeling to control for
                                                                                                                (preventive,            children born in North                                                                           selection bias
                                                                                                                restorative, and        Carolina in 1992
                                                                                                                emergency)              (1993-97)
                                                                                         Lee et al. (2004b)     Dental-care-related     Longitudinal linked data     WIC and non-WIC        Participant vs.   Participation dummy        Multivariate regression
                                                                                                                Medicaid costs          base, including birth        Medicaid recipients    nonparticipant    (any participation per
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                        record, Medicaid, WIC,       ages 0-3                                 year)
                                                                                                                                        and Area Resource files      (n=49,795)
                                                                                                                                        for children born in
                                                                                                                                        North Carolina in 1992
                                                                                                                                        (1992-96)
                                                                                         Buescher et al.        Health care             Longitudinal linked data     WIC and non-WIC        Participant vs.   Dose response:             Multivariate regression;
                                                                                         (2003)                 utilization and costs   base, including birth,       Medicaid recipients    nonparticipant    Cumulative WIC             investigated but did not
                                                                                                                                        Medicaid, and WIC            ages 12-59 months                        participation defined as   implement selection-bias-
                                                                                                                                        records for children born    (n=16,335-21,277                         none, high, medium,        adjustment models
                                                                                                                                                                                                                      7
                                                                                                                                        in North Carolina in         for 4 age-specific                       and low
                                                                                                                                        1992. Data base              cohorts)
                                                                                                                                        includes data through
                                                                                                                                             th
                                                                                                                                        the 5 birthday
                                                                                                                                        (1992-97)
                                                                                         Lee et al. (2000)      Prevalence of           Longitudinal linked data     WIC and non-WIC        Participant vs.   Participation dummy        Multivariate regression
                                                                                                                anemia, failure to      base, including birth        infants and children   nonparticipant                               and proportional hazards
                                                                                                                                                                                                                                                8
                                                                                                                thrive, nutritional     record, Medicaid,            ages 0-59 months                                                    models
                                                                                                                deficiencies, and       AFDC/TANF, FSP, and          who received
                                                                                                                use of preventive       WIC files for all children   Medicaid benefits
                                                                                                                health care services    born in Illinois from 1990   continuously
                                                                                                                                        through 1996
                                                                                         Partington and         Dietary intake          CSFII data for Midwest       WIC and income-        Participant vs.   Participation dummy        Bivariate z-tests
                                                                                                                                                     9
                                                                                         Nitzke (1999)                                  region (1994)                eligible children      nonparticipant
                                                                                                                                                                     ages 2-5 (n=183)
                                                                                          See notes at end of table.                                                                                                                                     Continued—
81
                                                                                         Appendix table 8—Studies that examined the impact of the WIC program on nutrition and health outcomes of infants and children—Continued
82



                                                                                                                                                                   Population                                     Measure of
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                       1                       2
                                                                                         Study                         Outcome(s)          Data source           (sample size)             Design                 participation        Analysis method

                                                                                         Sherry et al.          Prevalence of         PedNSS data for          Infants and children   Prevalence            N/A                   Trends analysis
                                                                                         (2001)                 anemia                Colorado, New Mexico,    ages 6-59 months       estimates for
                                                                                                                                      Oklahoma, Utah, and      (5,500-48,000          each State in 5-
                                                                                                                                      Vermont (early 1980s-    records per State      year intervals
                                                                                                                                      mid-1990s) (most data    per year)              overall and by
                                                                                                                                      provided by WIC                                 age, race/
                                                                                                                                      programs)                                       ethnicity,
                                                                                                                                                                                      gender,
                                                                                                                                                                                      birthweight, and
                                                                                                                                                                                      type of
                                                                                                                                                                                      screening visit
                                                                                         Sherry et al.          Prevalence of         PedNSS data for          Infants and children   Prevalence            N/A                   Trends analysis
                                                                                         (1997)                 anemia                Vermont (1981-94)        ages 6-59 months       estimates for
                                                                                                                                      (most data provided by   (n=12,000-19,500       each year for
                                                                                                                                      WIC programs)            records per year)      overall sample
                                                                                                                                                                                      by age
                                                                                         Yip et al. (1987)      Prevalence of         (1) PedNSS data for      Infants and children   (1) Overall and       Participation dummy   (1) Linear regression;
                                                                                                                anemia                Arizona, Kentucky,       ages 6-60 months       age-specific                                angular chi-square
                                                                                                                                      Louisiana, Montana,      (1) (n=499,759)        prevalence                                  (2) Multivariate regression
                                                                                                                                      Oregon, and Tennessee    (2) (n=72,983)         estimates for
                                                                                                                                      (1975-85) (Most data                            each year:
                                                                                                                                      provided by WIC                                 Initial measures
                                                                                                                                      programs)                                       vs. followup
                                                                                                                                                                                      measures
                                                                                                                                      (2) Linked PedNSS and
                                                                                                                                      birth records for WIC                           (2) Participant vs.
                                                                                                                                      participants in                                 nonparticipant
                                                                                                                                      Tennessee PedNSS
                                                                                                                                      database (1975-84)
                                                                                         USDA/FNS               Hemoglobin,           WIC records in PedNSS    WIC infants and        Participants,         Participation dummy   Chi-square tests
Economic Research Service/USDA




                                                                                         (1978)                 hematocrit, height,   data for Arizona,        children ages 0-59     before vs. after
                                                                                                                and weight            Kentucky, Tennessee,     months with 3 or
                                                                                                                                      and Washington           more WIC visits at
                                                                                                                                      (1974-76)                approximately 6-
                                                                                                                                                               month intervals
                                                                                                                                                                         10
                                                                                                                                                               (n=5,692)
                                                                                          See notes at end of table.                                                                                                                              Continued—
Economic Research Service/USDA

                                                                                         Appendix table 8—Studies that examined the impact of the WIC program on nutrition and health outcomes of infants and children—Continued
                                                                                                                                                                      Population                                Measure of
                                                                                                                                                        1                         2
                                                                                         Study                         Outcome(s)           Data source             (sample size)            Design             participation            Analysis method

                                                                                         Group IV: Other State and local studies
                                                                                         Black et al. (2004)    Height, weight,       Primary data collection     WIC and income-       Participant vs.    Participation dummy,     Multivariate regression
                                                                                                                caregiver-perceived   at urban medical centers    eligible infants      nonparticipant     with non-WIC subjects
                                                                                                                health status, and    in Washington, DC,          younger than 12                          divided into those who
                                                                                                                                                                                   11
                                                                                                                household food        Baltimore, Minneapolis,     months (n=5,923)                         did not participate
                                                                                                                security              Boston, Little Rock, and                                             because of access
                                                                                                                                      Los Angeles (1998-                                                   issues and those who
                                                                                                                                      2001)                                                                did not perceive a
                                                                                                                                                                                                           need for WIC
                                                                                         Kahn et al. (2002)     Prevalence of         Medical records for 3       WIC infants and       Participants,      Participation dummy      Not well described
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                anemia                WIC sites in Chicago        children ages 6-59    before vs. after
                                                                                                                                      (1997-99)                   months (n=7,053)
                                                                                         Shaheen et al.         Immunization status   Primary data collection     WIC and non-WIC       Participant vs.    Participation dummy      Age-adjusted odds ratios
                                                                                         (2000)                                       (interviews and record      children ages 2-4     nonparticipant
                                                                                                                                      abstractions) in a          (n=270)
                                                                                                                                      predominantly Hispanic
                                                                                                                                      low-income area of Los
                                                                                                                                      Angeles (dates not
                                                                                                                                      reported)
                                                                                         James (1998)           Immunization status   Medical records for 1       Randomly selected     Participant vs.    Participation dummy      Chi-square tests
                                                                                                                                      health care center in Mt.   sample (matched       nonparticipant
                                                                                                                                      Vernon, NY                  on age and gender)
                                                                                                                                                                  of children who
                                                                                                                                                                  were up-to-date on
                                                                                                                                                                  immunizations at
                                                                                                                                                                  12 months of age;
                                                                                                                                                                  equal size groups
                                                                                                                                                                  (n=150)
                                                                                          See notes at end of table.                                                                                                                               Continued—
83
                                                                                         Appendix table 8—Studies that examined the impact of the WIC program on nutrition and health outcomes of infants and children—Continued
84



                                                                                                                                                                      Population                                 Measure of
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                         1                        2
                                                                                         Study                         Outcome(s)           Data source             (sample size)            Design              participation         Analysis method

                                                                                         Burstein et al.        Dietary intake,       Primary data collection     Random sample of      Participant vs.     Participation dummy   Multivariate regression,
                                                                                         (1991)                 hemoglobin,           in Florida and North        WIC and income-       nonparticipant                            including attempt to
                                                                                                                hematocrit, height,   Carolina (1990-91)          eligible infants (6                                             control for selection bias
                                                                                                                weight, and head                                  months old)
                                                                                                                circumference                                     stratified by
                                                                                                                                                                  birthweight (n=807)
                                                                                         Brown and              Dietary intake,       Primary data collection     WIC and income-       Participant vs.     Participation dummy   Chi-square test
                                                                                         Tieman (1986)          hemoglobin,           in low-income areas of 1    eligible children     nonparticipant
                                                                                                                hematocrit, height,   county in Minnesota         ages 1-5 (n=52)
                                                                                                                and weight            (dates not reported)
                                                                                         Smith et al.           Hemoglobin            Medical records for 1       Subset of random      Participants vs.    Participation dummy   Analysis of variance
                                                                                         (1986)                                       health center in Los        sample of WIC and     nonparticipants,
                                                                                                                                      Angeles; initial and 6-     non-WIC children      before and after
                                                                                                                                      month followup              ages 1-4 who were
                                                                                                                                      measures                    diagnosed with
                                                                                                                                                                  anemia; matched
                                                                                                                                                                  on age, gender,
                                                                                                                                                                  and ethnicity (n=25
                                                                                                                                                                  each group)
                                                                                         Miller et al. (1985)   Serum ferritin,       Medical records for 1       WIC and income-       Participants,       Participation dummy   Chi-square tests
                                                                                                                hematocrit, and       child and youth clinic in   eligible children     before vs. after,
                                                                                                                hemoglobin            Minneapolis (1973-74        ages 16-23 months     separate groups
                                                                                                                                      and 1977)                   (n~2,225)
                                                                                          See notes at end of table.                                                                                                                                Continued—
Economic Research Service/USDA
Economic Research Service/USDA

                                                                                         Appendix table 8—Studies that examined the impact of the WIC program on nutrition and health outcomes of infants and children—Continued
                                                                                                                                                                          Population                                  Measure of
                                                                                                                                                            1                         2
                                                                                         Study                         Outcome(s)               Data source             (sample size)             Design              participation         Analysis method

                                                                                         Vazquez-Seone          Hemoglobin                Medical records for        WIC and income-         Participants,       Participation dummy   Bivariate t-tests
                                                                                         et al. (1985)                                    children enrolled in an    eligible infants and    before vs. after,
                                                                                                                                          inner-city health center   children ages 9-36      separate groups
                                                                                                                                          in New Haven, CT,          months (n=583)
                                                                                                                                          before and after
                                                                                                                                          initiation of WIC
                                                                                         Hicks and              IQ scores and             Primary data collection    Sibling WIC pairs       Participant vs.     Participation dummy   Multivariate regression
                                                                                         Langham (1985)         school grades             and record abstractions    ages 8-10; 1            sibling control
                                                                                                                                          in 3 counties in rural     “participated” in
                                                                                                                                          Louisiana (dates not       WIC prenatally and
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                          reported)                  1 enrolled after age
                                                                                                                                                                     1 (n=19 sibling
                                                                                                                                                                     pairs)
                                                                                         Heimendinger et        Expected weight           Medical records in 3       WIC- and                Participant vs.     Participation dummy   Multivariate regression of
                                                                                                                    12
                                                                                         al. (1984)             gain                      WIC and 4 non-WIC          Medicaid-eligible       nonparticipant,                           “value-added” measures
                                                                                                                                          clinics in the same        infants and toddlers    (“value added”or                          by age group (3-month
                                                                                                                                          Boston neighborhoods       up to 20 months         expected growth                           intervals)
                                                                                                                                          (1974-79)                  with at least 2         vs. actual
                                                                                                                                                                     height and weight       growth)
                                                                                                                                                                     measurements
                                                                                                                                                                     (n=1,907)
                                                                                         Paige (1983)           Medicaid costs and        Medicaid records in 4      WIC and income-         Participant vs.     Participation dummy   Comparison of means and
                                                                                                                health care               counties in Maryland, 2    eligible infants ages   nonparticipant                            proportions (no statistical
                                                                                                                utilization               in which WIC was           0-11 months who                                                   tests reported)
                                                                                                                                          available and 2 in which   were on Medicaid
                                                                                                                                          WIC was not available      for at least 75% of
                                                                                                                                          (1979-80)                  study period
                                                                                                                                                                     (n=138)
                                                                                         Hicks et al. (1982)    Hemoglobin, height,       Primary data collection    Sibling WIC pairs       Participant vs.     Participation dummy   Multivariate regression
                                                                                                                weight, and a             and record abstractions    ages 6-8; 1             sibling control
                                                                                                                variety of intellectual   in 3 rural counties in     “participated” in
                                                                                                                and behavioral            Louisiana (dates not       WIC prenatally and
                                                                                                                measures                  reported)                  1 enrolled after age
                                                                                                                                                                     1 (n=21 sibling
                                                                                                                                                                     pairs)
                                                                                          See notes at end of table.                                                                                                                                       Continued—
85
                                                                                         Appendix table 8—Studies that examined the impact of the WIC program on nutrition and health outcomes of infants and children—Continued
86



                                                                                                                                                                                Population                                         Measure of
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                                1                           2
                                                                                         Study                        Outcome(s)                  Data source                 (sample size)                Design                  participation                Analysis method

                                                                                         Weiler et al.           Hemoglobin                 WIC records in 1 clinic        Infants ages 0-6          Participants,          Participation dummy           Bivariate t-tests
                                                                                         (1979)                                             in Fayette Co, KY              months initially          before vs. after
                                                                                                                                            (1976-77)                      certified for WIC
                                                                                                                                                                           because of anemia
                                                                                                                                                                           who had followup
                                                                                                                                                                           hemoglobin
                                                                                                                                                                           measure available
                                                                                                                                                                           (n=37)
                                                                                           Note: N/A = Not applicable.
                                                                                           1
                                                                                             Data sources:
                                                                                                CCDP = Comprehensive Child Development Programs.
                                                                                                CSFII = Continuing Survey of Food Intakes by Individuals.
                                                                                                FITS = Feeding Infants and Toddlers Study.
                                                                                                NHANES-III = Third National Health and Nutrition Examination Survey.
                                                                                                NIS = National Immunization Survey.
                                                                                                NLSY = National Longitudinal Survey of Youth.
                                                                                                PedNSS = Pediatric Nutrition Surveillance System.
                                                                                                SIPP = Survey of Income and Program Participation.
                                                                                           2
                                                                                             Unless the description of the study sample indicates that a comparison group was limited to nonparticipants who were income-eligible for WIC or known to be Medicaid participants, all
                                                                                         income levels were included in the comparison group. Income was generally controlled for in the analysis.
                                                                                           3
                                                                                             Definition of comparison group varies for different outcomes. Children who never participated in WIC were main comparison group and were compared with former and/or current WIC
                                                                                         participants.
                                                                                           4
                                                                                             Also estimated a multivariate model of the relationship between intensity of WIC immunization activities and immunization coverage rates for WIC participants.
                                                                                           5
                                                                                             Roughly half of the sample was assessed in the first year of life and half was assessed between their first and second birthdays.
                                                                                           6
                                                                                             Authors also ran regression for full sample of WIC and income-eligible children. That model resulted in more significant effects.
                                                                                           7
                                                                                             WIC participation defined based on percentage of months from age 1 through current age in which WIC vouchers had been redeemed. High = more than 66 percent, Medium = 34-66
                                                                                         percent, and Low = 33 percent or less.
                                                                                           8
                                                                                             To control for the fact that several outcomes under study might be reasons for WIC enrollment, WIC participation was coded as zero if diagnosis of a particular problem preceded the date
                                                                                         of WIC enrollment.
                                                                                           9
                                                                                             CSFII data included two recalls per subject, but authors used only the first recall. Used only data for 1994 because, at the time the study was conducted, only that portion of the 1994-96
                                                                                         data set had been coded for food group consumption.
Economic Research Service/USDA




                                                                                           10
                                                                                              Maximum sample; sample size varies for each outcome.
                                                                                           11
                                                                                              Information on income was not collected. Receipt of private health insurance was used as a proxy for income, and the non-WIC sample was limited to infants without private insurance.
                                                                                           12
                                                                                              A doctoral dissertation completed by Heimendinger in 1981 included data on height and weight-for-height. However, these data were dropped from the peer-reviewed journal article
                                                                                         because of substantial problems with missing data.
Economic Research Service/USDA

                                                                                         Appendix table 9—Studies that examined the impact of the WIC program on nutrition and health outcomes of nonbreastfeeding postpartum
                                                                                         women, breastfeeding women, all WIC participants, or WIC households
                                                                                                                                                                          Population                               Measure of
                                                                                                                                                           1
                                                                                         Study                         Outcome(s)            Data source                (sample size)           Design             participation         Analysis method

                                                                                         Nonbreastfeeding postpartum women
                                                                                         Pehrsson et al.        Dietary iron intake,   WIC sites in Maryland         Low-risk WIC and      Participant vs.    Participation dummy   Bivariate t-tests,
                                                                                         (2001)                 several biochemical    with differing policies for   income-eligible       nonparticipant                           chi-square tests, and
                                                                                                                indicators of iron     certifying low-risk           postpartum                                                     analysis of variance
                                                                                                                status                 postpartum women              (nonbreastfeeding)
                                                                                                                                       (1994-95)                     women (n=110)
                                                                                         Kramer-LeBlanc         Dietary intake         1988-94 NHANES-III            WIC and income-       Participant vs.    Participation dummy   Bivariate t-tests
                                                                                         et al. (1999)                                                               eligible postpartum   nonparticipant
                                                                                                                                                                     (nonbreastfeeding)
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                                     women (n=190)
                                                                                         Caan et al. (1987)     Birthweight, birth     47 local WIC agencies         Pregnant WIC          Participant vs.    Participation dummy   Multivariate regression
                                                                                                                length, weight         in California (1983)          participants, some    nonparticipant
                                                                                                                status, hemoglobin,                                  of whom had
                                                                                                                prevalence of                                        extended
                                                                                                                anemia                                               postpartum WIC
                                                                                                                                                                     participation for a
                                                                                                                                                                     previous pregnancy
                                                                                                                                                                     and some of whom
                                                                                                                                                                     had limited or no
                                                                                                                                                                     postpartum WIC
                                                                                                                                                                     participation
                                                                                                                                                                     (n=642)
                                                                                         Breastfeeding women
                                                                                         Kramer-LeBlanc         Dietary intake         1988-94 NHANES-III            WIC and income-       Participant vs.    Participation dummy   Bivariate t-tests
                                                                                         et al. (1999)                                                               eligible              nonparticipant
                                                                                                                                                                     breastfeeding
                                                                                                                                                                     women (n=56)
                                                                                         Argeanas and           Dietary intake         1 local WIC agency in         WIC and non-WIC       Participant vs.    Participation dummy   Bivariate t-tests
                                                                                         Harrill (1979)                                Colorado and 1                breastfeeding         nonparticipant,
                                                                                                                                       unaffiliated prenatal         women (n=16)          before and after
                                                                                                                                       clinic (1978)
                                                                                         WIC households or all WIC participants
                                                                                         Wilde et al.           Dietary intake         1994-96 CSFII                 Low-income            Participant vs.    Participation dummy   Maximum likelihood
                                                                                         (2000)                                                                      households            nonparticipant                           estimation
                                                                                                                                                                     (n=1,901)
                                                                                          See notes at end of table.                                                                                                                                    Continued—
87
88

                                                                                         Appendix table 9—Studies that examined the impact of the WIC program on nutrition and health outcomes of nonbreastfeeding postpartum
                                                                                         women, breastfeeding women, all WIC participants, or WIC households—Continued
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                                             Population                                Measure of
                                                                                                                                                               1
                                                                                         Study                         Outcome(s)                 Data source              (sample size)             Design            participation          Analysis method

                                                                                         Basiotis et al.          Dietary intake            1989-91 CSFII               Low-income              Dose-response     Participation dummy;   Multivariate regression
                                                                                         (1998)                                                                         households                                benefit amount
                                                                                                                                                                        (n=1,379)
                                                                                         Arcia et al. (1990)      Food expenditures         NWE (1983-84)               Nationally              Participant vs.   Participation dummy    Multivariate regression
                                                                                                                                                                        representative          nonparticipant
                                                                                                                                                                        sample of pregnant
                                                                                                                                                                        WIC participants
                                                                                                                                                                        and income-eligible
                                                                                                                                                                        nonparticipants
                                                                                                                                                                        receiving prenatal
                                                                                                                                                                        care in surrounding
                                                                                                                                                                        public health clinics
                                                                                                                                                                        and hospitals
                                                                                                                                                                        (n=3,935)
                                                                                         Taren et al.             Food intake               Food cooperatives and       Low-income              Participant vs.   Participation dummy    Multivariate regression
                                                                                         (1990)                                             EFNEP programs in           households              nonparticipant
                                                                                                                                            Hillsborough Country,       (n=157)
                                                                                                                                            Florida (dates not
                                                                                                                                            reported)
                                                                                         Rush et al.              Food expenditures         Primary data collection     Nationally              Participant vs.   Participation dummy    Multivariate regression
                                                                                         (1988b)                                            (1983-84)                   representative          nonparticipant
                                                                                                                                                                        sample of pregnant
                                                                                                                                                                        WIC participants
                                                                                                                                                                        and income-eligible
                                                                                                                                                                        nonparticipants
                                                                                                                                                                        receiving prenatal
                                                                                                                                                                        care in surrounding
                                                                                                                                                                        public health clinics
Economic Research Service/USDA




                                                                                                                                                                        and hospitals
                                                                                                                                                                        (n=3,935)
                                                                                           1
                                                                                               Data sources:
                                                                                                 CSFII = Continuing Survey of Food Intakes by Individuals.
                                                                                                 EFNEP = Expanded Food and Nutrition Education Program.
                                                                                                 NWE = National WIC Evaluation.
                                                                                                 NHANES-III = Third National Health and Nutrition Examination Survey.
                                 National School Lunch Program




Economic Research Service/USDA   Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4   89
90

                                                                                         Appendix table 10—Studies that examined the impact of the National School Lunch Program on students’ dietary intakes
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4



                                                                                                                                                  Data collection      Population                           Measure of
                                                                                                                                            1
                                                                                         Study                Outcome(s)       Data source           method          (sample size)          Design          participation         Analysis method

                                                                                         Group I: National evaluations
                                                                                         Devaney            Nutrient intake   Nationally        Single 24-hour      Children and       Participant vs.   Ate NSLP lunch on   Multivariate regression
                                                                                         et al. (1993)      at lunch and      representative    recall              adolescents in     nonparticipant    recall day          with selection-bias-
                                                                                         (SNDA-I)           over 24 hours     sample of                             grades 1-12                                              adjustment (nutrients)
                                                                                                                              students from                         (n~3,350)
                                                                                                            Food intake at                                                                                                   Bivariate t-tests (foods)
                                                                                                                              329 public and
                                                                                                            lunch
                                                                                                                              private schools
                                                                                                                              (1991-92)
                                                                                         Wellisch et al.    Nutrient intake   Nationally        Single 24-hour      Children and       Participant vs.   Ate NSLP lunch on   Multivariate regression
                                                                                         (1983)             at lunch and      representative    recall              adolescents in     nonparticipant    recall day
                                                                                         (NESNP)            over 24 hours     sample of                             grades 1-12
                                                                                                                              students from                         (n=6,556)
                                                                                                                              276 public
                                                                                                                              schools
                                                                                                                              (1980-81)
                                                                                         Group II: Secondary analysis of national surveys
                                                                                         Gleason and        Nutrient intake   1994-96 CSFII     2 nonconsecutive    Children and       Participant vs.   Ate NSLP lunch on   Multivariate regression
                                                                                         Suitor (2003)      at lunch and                        24-hour recalls     adolescents        nonparticipant    recall day          with fixed-effects model
                                                                                                            over 24 hours                                           ages 6-18 with                                           to control for selection
                                                                                                                                                                    2 days of intake                                         bias
                                                                                                                                                                    data (n=1,614)
                                                                                         Gleason and        Nutrient intake   1994-96 CSFII     2 nonconsecutive    Children and       Participant vs.   Ate NSLP lunch on   Comparison of
                                                                                         Suitor (2001)      at lunch and                        24-hour recalls     adolescents        nonparticipant    recall day          regression-adjusted
                                                                                                            over 24 hours                                           ages 6-18 with 1                                         means
                                                                                                                                                                    or 2 school days
                                                                                                            Food intake at
                                                                                                                                                                    of intake data
                                                                                                            lunch and over
                                                                                                                                                                    (n=1,866)
                                                                                                            24 hours
Economic Research Service/USDA




                                                                                         Fraker (1987)      Nutrient intake   1980-81 NESNP     Single 24-hour      Children and       Participant vs.   Ate NSLP lunch on   Bivariate t-tests for full
                                                                                                            at lunch and                        recall              adolescents in     nonparticipant    recall day          sample and low-income
                                                                                                            over 24 hours                                           grades 1-12                                              sample
                                                                                                                                                                    (n=6,556)
                                                                                          See notes at end of table.                                                                                                                         Continued—
Economic Research Service/USDA

                                                                                         Appendix table 10—Studies that examined the impact of the National School Lunch Program on students’ dietary intakes—Continued
                                                                                                                                                     Data collection         Population                             Measure of
                                                                                                                                            1
                                                                                         Study                 Outcome(s)       Data source             method             (sample size)        Design              participation          Analysis method
                                                                                         Akin et al.         Nutrient intake   1977-78 NFCS       24-hour recall plus     Children and     Participant vs.      Ratio of number of     Multivariate regression
                                                                                                                                                                                                          2,3
                                                                                         (1983a)             over 24 hours                        2-day food record       adolescents      nonparticipant       days ate school
                                                                                                                                                                          ages 6-18                             lunch to number of
                                                                                                                                                                          (n=1,554)                             days of dietary data
                                                                                         Akin et al.         Nutrient intake   1977-78 NFCS       24-hour recall plus     Children and     Participant vs.      Ratio of number of     Switching regression;
                                                                                                                                                                                                          4
                                                                                         (1983b)             over 24 hours                        2-day food record       adolescents      nonparticipant       days ate school        Chow tests
                                                                                                                                                                          ages 6-18                             lunch to number of
                                                                                                                                                                          (n=1,554)                             days ate any lunch
                                                                                         Hoagland            Nutrient intake   1971-74            Single 24-hour          Children and     Participant vs.      Ate school lunch on    Analysis of variance
                                                                                                                                                                                                          2
                                                                                         (1980)              over 24 hours     NHANES-I           recall                  adolescents      nonparticipant       recall day
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                                          ages 6-21
                                                                                                                                                                          (n=3,155)
                                                                                         Group IIIA: State and local studies with large samples
                                                                                         Rainville           Nutrient intake   Students in 10     Visual observation      Children in      Participant vs.      Ate school lunch on    Analysis of variance
                                                                                         (2001)              at lunch          schools in         of food selection       grades 2-4       nonparticipant       observation day (vs.
                                                                                                             Food intake at    southeastern       and waste               (n=570)                               sack lunch)
                                                                                                             lunch             Michigan (1998)
                                                                                         Melnick et al.      Food intake       All students in    Single 24-hour recall   Children in      Participant vs.      Ate school lunch on    Gender-adjusted anlaysis
                                                                                                                                                                                                          2
                                                                                         (1998)              over 24 hours     randomly           (nonquantitative)       grades 2 and 5   nonparticipant       recall day             of covariance
                                                                                                                               selected                                   (n=1,397)
                                                                                                                               classrooms in
                                                                                                                               25 sampled
                                                                                                                               public and
                                                                                                                               private schools
                                                                                                                               in New York City
                                                                                                                               (1989-90)
                                                                                         Wolfe and           Food intake       Students in 51     Single 24-hour recall   Children in      Participant vs.      Ate school lunch on    Bivariate t-tests and
                                                                                         Campbell            at lunch          schools in New     (nonquantitative)       grades 2 and 5   nonparticipant       recall day             chi-square tests
                                                                                         (1993)                                York State,                                (n=1,797)
                                                                                                                               excluding New
                                                                                                                               York City
                                                                                                                               (1987-88)
                                                                                           See notes at end of table.                                                                                                                                 Continued—
91
92

                                                                                         Appendix table 10—Studies that examined the impact of the National School Lunch Program on students’ dietary intakes—Continued
                                                                                                                                                       Data collection         Population                              Measure of
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                              1
                                                                                         Study                 Outcome(s)        Data source              method             (sample size)         Design              participation           Analysis method
                                                                                         Price et al.        Nutrient intake   Students in          3 nonconsecutive        Children ages     Participant vs.      Participation          Multivariate regression
                                                                                         (1978)              over 24 hours     schools/districts    24-hour recalls,        8-12 (n=728)      nonparticipant       dummies based on
                                                                                                                               in 8 regions in      including 1 weekend                                            usual frequency:
                                                                                                                               Washington           day                                                            0-1 time per week,
                                                                                                                               State, Blacks                                                                       2-3 times per week,
                                                                                                                               and Mexican-                                                                        4-5 times per week
                                                                                                                               Americans were
                                                                                                                               oversampled
                                                                                                                               (1971-73)
                                                                                         Emmons et al.       Nutrient intake   All students in      Single 24-hour recall   Children in       Participants,        Took 70% or more       Comparison of means
                                                                                                                                                                                                               6
                                                                                         (1972)              at lunch and      selected grades                              grades 1-4        before vs. after     of school meals        (type of statistical test not
                                                                                                             over 24 hours     in 1 district in                             (n=512)                                offered during study   reported)
                                                                                                                               rural New York                                                                      period
                                                                                                                                                5
                                                                                                                               State (1970-71)
                                                                                         U.S.                Nutrient intake   Sample of            Single 24-hour          Children and      Participant vs.      Usually ate school     Comparison of means
                                                                                                                                                                                                             2
                                                                                         Department of       over 24 hours     children from 10     recall                  adolescents       nonparticipant       lunch at least         (no statistical tests
                                                                                         Health,                               States, plus                                 ages 10-16                             3 times/week           reported)
                                                                                         Education,                            volunteers                                   (n=8,495)
                                                                                         and Welfare                           (1972)
                                                                                         (HEW) (10-
                                                                                         State Nutrition
                                                                                         Survey)
                                                                                         Group IIIB: State and local studies with small samples
                                                                                         Cullen et al.       Food intake at    Students in 1        5 consecutive daily     Children in       Participant vs.      Ate NSLP lunch (vs.    Analysis of variance
                                                                                         (2000)              lunch             middle school in     food records            grade 5 (n=282)   nonparticipant       home lunch or
                                                                                                                               Texas (dates not                                                                    snack bar lunch) on
                                                                                                                               reported)                                                                           food record days
                                                                                         Ho et al.           Nutrient intake   Students in 1        Visual observation      Children and      Participant vs.      Ate NSLP lunch (vs.    Analysis of variance and
                                                                                         (1991)              at lunch          middle school in     of food selection       adolescents in    nonparticipant       sack lunch or          Student-Newman-Keuls
                                                                                                                               Salt Lake City       and waste               grades 7 and 8                         vending machine        range test
Economic Research Service/USDA




                                                                                                                               (1989)                                       (n=254)                                lunch) on
                                                                                                                                                                                                                   observation day
                                                                                         Perry et al.        Nutrient intake   All students in      3-day food record       Children in       Participant vs.      Ate NSLP lunch (vs.    Unmatched t-test
                                                                                                                                                                                                             7
                                                                                         (1984)              at lunch          selected                                     grades 5 and 6    nonparticipant       brown bag lunch) on
                                                                                                                               classrooms in 3                              (n=233)                                food record days
                                                                                                                               schools in 1
                                                                                                                               district in
                                                                                                                               Alabama
                                                                                           See notes at end of table.                                                                                                                                     Continued—
Economic Research Service/USDA

                                                                                         Appendix table 10—Studies that examined the impact of the National School Lunch Program on students’ dietary intakes—Continued
                                                                                                                                                            Data collection             Population                                     Measure of
                                                                                                                                                  1
                                                                                         Study                 Outcome(s)           Data source                method                 (sample size)              Design                participation              Analysis method
                                                                                         Howe and            Nutrient intake      Randomly               Single 24-hour             Adolescents in         Participant vs.        Ate NSLP lunch on          2-way analysis of
                                                                                         Vaden (1980)        at lunch and         selected               recall                     grades 10              nonparticipant         recall day                 variance
                                                                                                             over 24 hours        students in 1                                     and 11 (n=104)
                                                                                                                                  urban public
                                                                                                                                  high school in
                                                                                                                                  Kansas
                                                                                         Yperman and         Food intake          All students in 2      Food frequency             Children in            Participant vs.        Number of days ate         Multivariate regression
                                                                                         Vermeersch          over 24 hours        classrooms per         checklist                  grades 1-3             nonparticipant         school lunch on 5
                                                                                         (1979)                                   grade in 2                                        (n=307)                                       days prior to data
                                                                                                                                  schools in                                                                                      collection
                                                                                                                                  California
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                           1
                                                                                             Data sources:
                                                                                                CSFII = Continuing Survey of Food Intakes by Individuals.
                                                                                                NHANES-I = First National Health and Nutrition Examination Survey.
                                                                                                NFCS = Nationwide Food Consumption Survey.
                                                                                           2
                                                                                             Did not differentiate NLSP and other lunch programs.
                                                                                           3
                                                                                             Included lunch skippers with nonparticipants.
                                                                                           4
                                                                                             Accounted for lunch skippers.
                                                                                           5
                                                                                             Study included a second district where both free lunch and free breakfast were offered. The two districts were considered separately in the analysis, but the analysis of the second district
                                                                                         did not separate contributions of breakfast and lunch meals.
                                                                                           6
                                                                                             Study compared intakes before and after introduction of a free lunch program. Results were reported for four different subgroups based on baseline characteristics: nutritionally adequate,
                                                                                         nutritionally needy, low-income (eligible for free lunch), and not low-income.
                                                                                           7
                                                                                             Unit of analysis was lunches rather than students; 60 percent of students ate NSLP daily.
93
94

                                                                                         Appendix table 11—Studies that examined the impact of the National School Lunch Program on other nutrition and health outcomes
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4



                                                                                                                                                           Population                                          Measure of
                                                                                                                                          1
                                                                                         Study                               Data source                 (sample size)                 Design                  participation             Analysis method

                                                                                         Weight and/or height
                                                                                         Jones et al. (2003)           1997 PSID, Child            Children ages 5-12 with    Participant vs.            Parent report that child    Multivariate regression
                                                                                                                       Development                 household incomes          nonparticipant             “participates”
                                                                                                                       Supplement                  @185% of poverty (n=772)
                                                                                         Wolfe et al. (1994)           Students in 51 schools in   Children in grades 2 and   Participant vs.            Parent report that “child   Multivariate regression
                                                                                                                       New York State,             5 (n=1,797)                nonparticipant             eats school lunch”
                                                                                                                       excluding New York City
                                                                                                                       (1987-88)
                                                                                         Wellisch et al. (1983)        Nationally representative   Children and               Participant vs.            Average long-term           Multivariate regression
                                                                                         (NESNP)                       sample of students from     adolescents in             nonparticipant             weekly participation
                                                                                                                       276 public schools          grades 1-12 (n=6,556)
                                                                                                                       (1980-81)
                                                                                         Gretzen and                   All students in 2           Children and               Participant vs.            Began receiving free        Analysis of variance;
                                                                                                          2
                                                                                         Vermeersch (1980)             intervention programs       adolescents in             nonparticipant             school lunch in grade 1     bivariate t-tests
                                                                                                                       and 2 comparison            grades 1-8 (n=332)                                    and regularly through
                                                                                                                       programs in 1 SFA in                                                              grade 8
                                                                                                                       California
                                                                                         Emmons et al. (1972)          All students in selected    Children in grades 1-4     Participants, before       Took 70% or more of         Comparison of means
                                                                                                                                                                                       4
                                                                                                                       grades in 1 district in     (n=844)                    vs. after                  school meals offered        (type of statistical test
                                                                                                                       rural New York State                                                              during study period         not reported)
                                                                                                                                 3
                                                                                                                       (1970-71)
                                                                                         Paige (1972)                  Students in 4 schools in    Children in grades 1, 2,   Participant vs.            Not reported                Comparison of means
                                                                                                                       Baltimore, MD               and 6 (n=742)              nonparticipant, before                                 (type of statistical test
                                                                                                                                                                              and after                                              not reported)
                                                                                         Nutritional biochemistries
                                                                                         Kandiah and                   Students in 1 school in     Children/adolescents       Participants, before vs.   Ate school lunch at least   Multivariate regression
Economic Research Service/USDA




                                                                                         Peterson (2001)               Indiana                     ages 11-15 (n=3,155)       after (cholesterol)        3 times per week
                                                                                         Hoagland (1980)               1971-74 NHANES-I            Children and               Participant vs.            Ate school lunch on         Linear regression
                                                                                                                                                                                             5
                                                                                                                                                   adolescents ages 6-21      nonparticipant (iron,      recall day
                                                                                                                                                   (n=3,155)                  cholesterol, protein)
                                                                                          See notes at end of table.                                                                                                                                 Continued—
                                                                                         Appendix table 11—Studies that examined the impact of the National School Lunch Program on other nutrition and health outcomes—Continued
Economic Research Service/USDA



                                                                                                                                                                  Population                                                      Measure of
                                                                                                                                              1
                                                                                         Study                                  Data source                     (sample size)                       Design                        participation                 Analysis method

                                                                                         Emmons et al. (1972)            All students in 2 selected      Children in grades 1-4           Participants, before vs.        Took 70% or more                 Comparison of means
                                                                                                                         grades in 1 district in         (n=844)                          after (iron)                    school meals offered             (type of statistical test
                                                                                                                                                                                                                                             4
                                                                                                                         rural New York State                                                                             during study period              not reported)
                                                                                                                                   3
                                                                                                                         (1970-71)
                                                                                         Paige (1972)                    Students in 4 schools in        Children in grades 1, 2,         Participants vs.                Not reported                     Comparison of means
                                                                                                                         Baltimore, MD                   and 6 (n=742)                    nonparticipants, before                                          (type of statistical test
                                                                                                                                                                                          and after (iron)                                                 not reported)
                                                                                         Household food expenditures
                                                                                         Long (1991)                     1980-81 NESNP                   Children and                     Participant vs.                 Any household member             Multivariate regression
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                         adolescents in grades            nonparticipant                  participates in NSLP at          with selection-bias
                                                                                                                                                                                                                                                                       6
                                                                                                                                                         1-12 (n=5,778)                                                   least once during a              adjustment
                                                                                                                                                                                                                          typical week
                                                                                         Wellisch et al. (1983)          Nationally representative       Children and                     Participant vs.                 Current weekly NSLP              Multivariate regression
                                                                                         (NESNP)                         sample of students in           adolescents in grades            nonparticipant                  participation
                                                                                                                         276 public schools              1-12 (n=6,556)
                                                                                                                         (1980-81)
                                                                                         West and Price (1976)           Students in schools/            Children ages 8-12               Participant vs.                 Value of free school             Multivariate regression.
                                                                                                                         districts in 8 regions in       (n=992)                          nonparticipant                  lunches (dollars per             Separate models for
                                                                                                                         Washington State;                                                                                month)                           Blacks, Whites, Mexican-
                                                                                                                         Blacks and Mexican-                                                                                                               Americans.
                                                                                                                         Americans were
                                                                                                                         oversampled (1972-73)
                                                                                           1
                                                                                             Data sources:
                                                                                                NESNP = National Evaluation of School Nutrition Programs.
                                                                                                NHANES-I = First National Health and Nutrition Examination Survey.
                                                                                                PSID = Panel Study of Income Dynamics, Child Development Supplement.
                                                                                           2
                                                                                             Study also examined physical fitness, school attendance, and academic performance.
                                                                                           3
                                                                                             Study included a second district where both free lunch and free breakfast were offered. The two districts were considered separately in the analysis, but the analysis of the second
                                                                                         district did not separate contributions of breakfast and lunch meals.
                                                                                           4
                                                                                             Study compared intakes before and after introduction of a free lunch program. Results reported for four different subgroups based on baseline characteristics: nutritionally adequate,
                                                                                         nutritionally needy, low-income (eligible for free lunch), and not low-income.
                                                                                           5
                                                                                             Did not differentiate NLSP and other lunch programs.
                                                                                           6
                                                                                             Participation measure not same week as expenditure measure; included NSLP and SBP in expenditures.
95
                                    School Breakfast Program




Economic Research Service/USDA   Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4   97
98

                                                                                         Appendix table 12—Studies that examined the impact of the School Breakfast Program on students’ dietary intakes
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4



                                                                                                                                                   Data collection      Population                              Measure of
                                                                                                                                             1
                                                                                         Study                 Outcome(s)       Data source           method          (sample size)            Design           participation            Analysis method

                                                                                         Group I: National evaluations
                                                                                         Devaney and         Likelihood        Nationally        Single 24-hour      Children and         Participant vs.   Ate SBP breakfast       Multivariate regression
                                                                                         Stuart (1998)       of eating         representative    recall              adolescents in       nonparticipant    on recall day           with selection-bias
                                                                                         (SNDA-I)            breakfast         sample of                             grades 1-12                                                    adjustment
                                                                                                                               students from                         (n=2,966)
                                                                                                                               329 public and
                                                                                                                               private schools
                                                                                         Gordon et al.       Nutrient intake   Nationally        Single 24-hour      Children and         Participant vs.   Ate SBP breakfast       Multivariate regression
                                                                                         (1995)              at breakfast      representative    recall              adolescents in       nonparticipant    on recall day           with selection-bias
                                                                                         (SNDA-I)            and over 24       sample of                             grades 1-12                                                    adjustment (nutrients)
                                                                                                             hours             students from                         (n=2,966)
                                                                                                                               329 public and                                                                                       Bivariate t-tests (foods)
                                                                                                             Food intake at
                                                                                                                               private schools
                                                                                                             breakfast
                                                                                         Wellisch et al.     Nutrient intake   Nationally        Single 24-hour      Children and         Participant vs.   Ate SBP breakfast       Multivariate regression
                                                                                         (1983)              at breakfast      representative    recall              adolescents in       nonparticipant    and NSLP lunch on
                                                                                         (NESNP)             and over 24       sample of                             grades 1-12                            recall day (nonparti-
                                                                                                                   2
                                                                                                             hours             students from                         (n=2,180)                              cipants ate NSLP
                                                                                                                               276 public                                                                   lunch only)
                                                                                                                               schools
                                                                                         Group II: Secondary analysis of national surveys
                                                                                         Gleason and         Nutrient intake   1994-96 CSFII     2 nonconsecutive    Children and         Participant vs.   Ate SBP breakfast       Comparison of
                                                                                         Suitor (2001)       at breakfast                        24-hour recalls     adolescents in       nonparticipant    on recall day           regression-adjusted
                                                                                                             and over 24                                             SBP schools                                                    means
                                                                                                             hours                                                   ages 6-18
                                                                                                                                                                     (n=2,693)
                                                                                                             Food intake at
                                                                                                             breakfast and
                                                                                                             over 24 hours
Economic Research Service/USDA




                                                                                         Basiotis et al.     Nutrient intake   1994-96 CSFII     2 nonconsecutive    Low-income           Participant vs.   Ate SBP breakfast       Multivariate regression
                                                                                         (1999)              over 24 hours                       24-hour recalls     children ages        nonparticipant    on recall day
                                                                                                                                                                     6-18 (sample
                                                                                                             Food intake
                                                                                                                                                                     size not reported)
                                                                                                             over 24 hours
                                                                                         Devaney and         Nutrient intake   1980-81 NESNP     Single 24-hour      Children ages        Participant vs.   Ate SBP breakfast       Multivariate regression
                                                                                         Fraker (1989)       at breakfast                        recall              5-10 (n=2,118)       nonparticipant    on recall day
                                                                                                             and over 24                                             and 11-21
                                                                                                             hours                                                   (n=2,809)
                                                                                           See notes at end of table.                                                                                                                              Continued—
                                                                                         Appendix table 12—Studies that examined the impact of the School Breakfast Program on students’ dietary intakes—Continued
Economic Research Service/USDA



                                                                                                                                                     Data collection        Population                              Measure of
                                                                                                                                              1
                                                                                         Study                 Outcome(s)        Data source            method            (sample size)         Design              participation           Analysis method

                                                                                         Hoagland            Nutrient intake   1971-74             Single 24-hour        Children and      Participant vs.      Ate school breakfast   Analysis of variance
                                                                                                                           2
                                                                                         (1980)              over 24 hours     HANES-I             recall                adolescents       nonparticipant       on recall day
                                                                                                                                                                         ages 6-21
                                                                                                                                                                                 3
                                                                                                                                                                         (n=412)
                                                                                         Group III: State and local studies
                                                                                         Nicklas et al.      Nutrient intake   Bogalusa Heart      Single 24-hour        Children age 10   Participant vs.      Ate school breakfast   Analysis of variance
                                                                                         (1993a)             at breakfast      Study (1984-85      recall                (n=393)           nonparticipant       on recall day
                                                                                                                               and 1987-88)
                                                                                         Nicklas et al.      Nutrient intake   Bogalusa Heart      Single 24-hour        Children age 10   Participant vs.      Ate school breakfast   Analysis of variance
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                         (1993b)             over 24 hours     Study (1984-85      recall                (n=393)           nonparticipant       on recall day
                                                                                                                               and 1987-88)
                                                                                         Emmons et al.       Nutrient intake   All students in 2   Single 24-hour        Children in       Participants,        Took 70% or more       Comparison of means
                                                                                                                                                                                                            4
                                                                                         (1972)              at breakfast      school districts    recall                grades 1-4        before vs. after     of school meals        (type of statistical test not
                                                                                                             and over 24       in rural New                              (n=844)                                offered during study   reported)
                                                                                                                   2
                                                                                                             hours             York State                                                                       period
                                                                                                                               (1970-71)
                                                                                         Hunt et al.         Nutrient intake   2 schools in        Single 24-hour        Children in       Participant vs.      60% participation in   Analysis of variance
                                                                                                                                                                                                          5
                                                                                         (1979)              over 24 hours     Compton, CA         recall                grades 3-6        nonparticipant       SBP on days in
                                                                                                                               (1970-71)                                 (n=555)                                school during
                                                                                                                                                                                                                experimental period
                                                                                         Price et al.        Nutrient intake   Students in         3 nonconsecutive      Children ages     Participant vs.      Usually ate school     Multivariate regression
                                                                                                                                                                                      6
                                                                                         (1978)              over 24 hours     schools/districts   24-hour recalls,      8-12 (n=728)      nonparticipant       breakfast 4-5
                                                                                                                               in 8 regions in     including 1 weekend                                          times/week
                                                                                                                               Washington          day
                                                                                                                               State; Blacks
                                                                                                                               and Mexican-
                                                                                                                               Americans were
                                                                                                                               oversampled
                                                                                                                               (1971-73)
                                                                                           See notes at end of table.                                                                                                                                  Continued—
99
100

                                                                                         Appendix table 12—Studies that examined the impact of the School Breakfast Program on students’ dietary intakes—Continued
                                                                                                                                                            Data collection             Population                                     Measure of
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                  1
                                                                                         Study                 Outcome(s)           Data source                method                 (sample size)              Design                participation              Analysis method

                                                                                         Group IV: Studies of universal-free breakfast
                                                                                         McLaughlin et       Nutrient intake      70 matched             24-hour recall, with       Children in            Randomized             Ate universal-free         Multivariate regression
                                                                                         al. (2002)          at breakfast         pairs of school        second recall for          grades 2-6             experiment             breakfast on recall        with Bloom correction to
                                                                                                                                                                                                                                      9
                                                                                                             and over 24          units in 6 school      subsample (usual           (n=4,290)                                     day                        assess impact on
                                                                                                                                            8
                                                                                                             hours                districts              intake)                                                                                             universal-free breakfast
                                                                                                                                                                                                                                                             participants (subgroup
                                                                                                             Food intake at
                                                                                                                                                                                                                                                             analyses)
                                                                                                             breakfast and
                                                                                                                          2,7
                                                                                                             over 24 hours
                                                                                         Cook et al.         Nutrient intake      Elementary             Single breakfast           Children in            Participant vs.        Ate SBP breakfast          Not well described.
                                                                                         (1996)              at breakfast         schools in             recall                     grades 3-6             nonparticipant         on recall day
                                                                                                                                  Central Falls, RI,                                (n=225)
                                                                                                                                  matched with
                                                                                                                                  schools in
                                                                                                                                  Providence, RI
                                                                                           1
                                                                                             Data sources:
                                                                                                CSFII = Continuing Survey of Food Intake of Individuals.
                                                                                                NHANES-I = First National Health and Nutrition Examination Survey.
                                                                                                NESNP = National Evaluation of School Nutrition Programs.
                                                                                           2
                                                                                             Also examined impacts on height and/or weight, but reported no significant findings.
                                                                                           3
                                                                                             The study compared SBP participants with students who did not have access to the SBP. Only three SBP participants were included in the sample.
                                                                                           4
                                                                                             Study compared intakes before and after introduction of free lunch (one district) and free lunch and breakfast (one district). Results reported for four different subgroups based on baseline
                                                                                         characteristics: nutritionally adequate, nutritionally needy, low-income (eligible for free lunch), not low income.
                                                                                           5
                                                                                             Study examined the effect of introducing a free breakfast program, comparing students in experimental school to control school that had no breakfast program.
                                                                                           6
                                                                                             School breakfast was not the main focus of the study. Only 20 children in the sample consumed a school breakfast.
                                                                                           7
                                                                                             The study also examined impacts on BMI and food security and found no significant effects.
                                                                                           8
                                                                                             The study focused on students in grades 2-6. For sampling/matching purposes, schools with different grade configurations (e.g., K-2 and 3-5) were considered one unit. There were a total
                                                                                         of 73 treatment schools and 70 control schools.
                                                                                           9
                                                                                             The study’s main analysis compared outcomes for the entire treatment group with outcomes for the entire control group. Findings discussed in this report, however, are from a separate
                                                                                         analysis that estimated impacts on students who actually participated in universal-free breakfast on the day of the recall.
Economic Research Service/USDA
Economic Research Service/USDA

                                                                                         Appendix table 13—Studies that examined the impact of universal-free breakfast programs on school performance and behavioral/cognitive outcomes
                                                                                                                                                   Data collection       Population                              Measure of
                                                                                         Study                 Outcomes        Data source            method           (sample size)          Design             participation         Analysis method

                                                                                         Peterson et al.    Attendance,      455 schools in      School records and   All children for   Participant vs.     Enrolled in           Logistic regression
                                                                                         (2003)             academic         Minnesota           standardized test    attendance         nonparticipant      universal-free
                                                                                                            achievement,     (1998-2002)         scores               measures;                              SBP school
                                                                                                            health, and                                               children in
                                                                                                            discipline                                                grades 3 and 5
                                                                                                                                                                      for academic
                                                                                                                                                                      measures
                                                                                                                                                                      (n=43,067)
                                                                                         McLaughlin et      Cognitive        70 matched          School records and   Children in        Randomized          Ate universal-free    Multivariate regression
                                                                                         al. (2002)         functioning,     pairs of school     standardized test    grades 2-6         experiment          breakfast on day of   with Bloom correction to
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                            attendance,      units in 6 school   scores               (n=4,290)                              measurement           asses impact on
                                                                                                            tardiness,       districts                                                                       (short-term           universal-free breakfast
                                                                                                                                          2
                                                                                                            behavior         (1999-2001)                                                                     cognitive             participants (subgroup
                                                                                                                                                                                                                          3
                                                                                                            academic                                                                                         functioning)          analysis)
                                                                                                            achievement,
                                                                                                                                                                                                             Cumulative
                                                                                                            student health
                                                                                                                   1                                                                                         participation in
                                                                                                            status
                                                                                                                                                                                                             universal-free
                                                                                                                                                                                                             breakfast over the
                                                                                                                                                                                                             year (all other
                                                                                                                                                                                                                         3
                                                                                                                                                                                                             measures)
                                                                                         Murphy et al.      Attendance       48 schools in       School records and   All children in    Participants,       Enrolled in           Analysis of variance
                                                                                         (2001a)            and academic     Baltimore (1995-    standardized test    sample schools     before vs. after,   universal-free
                                                                                                            achievement      2000)               scores               (n=not stated)     separate            SBP school
                                                                                                                                                                                         groups, plus
                                                                                                                                                                                         participants vs.
                                                                                                                                                                                         nonparticipants,
                                                                                                                                                                                         before and after
                                                                                          See notes at end of table.                                                                                                                             Continued—
101
                                                                                         Appendix table 13—Studies that examined the impact of universal-free breakfast programs on
102


                                                                                         school performance and behavioral/cognitive outcomes—Continued
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                           Data collection             Population                                    Measure of
                                                                                         Study                  Outcomes            Data source               method                 (sample size)             Design                participation              Analysis method

                                                                                         Murphy et al.       Attendance,          55 schools in         School records and         Varied by             Participants,          Enrolled in               Analysis of variance;
                                                                                         (2001b)             tardiness,           Maryland              standardized test          outcome for           before vs. after,      universal-free            bivariate t-tests
                                                                                                             academic             (1997-2000)           scores                     both schools          separate               SBP school
                                                                                                             achievement                                                           and students          groups, plus
                                                                                                                                                                                                         participants vs.
                                                                                                                                                                                                         nonparticipants,
                                                                                                                                                                                                         before and after
                                                                                         Murphy et al.       Attendance,          30 schools in         School records,            All children in       Participants,          Frequency of eating       Analysis of variance
                                                                                         (2000)              tardiness,           Boston, MA            standardized test          sample schools        before vs. after       breakfast during 1
                                                                                                             academic             (1998-2000)           scores, parent and         (n=not stated)                               index week
                                                                                                             achievement,                               student interviews
                                                                                                             emotional
                                                                                                             functioning
                                                                                         Murphy et al.       Attendance,          1 school in           School records and         Children in           Participants,          Frequency of eating       Logistic regression
                                                                                         (1998)              psychological        Baltimore; 2          parent, teacher, and       grades 3-8            before vs. after       breakfast during 1
                                                                                                                                                                                           4
                                                                                                             measures,            schools in            student interviews         (n=133)                                      index week
                                                                                                             academic             Philadelphia
                                                                                                             achievement          (dates not
                                                                                                                                  reported)
                                                                                         Cook et al.         Attendance,          All elementary        School records             Children in           Participant vs.        Enrolled in               Not well described
                                                                                         (1996)              tardiness            schools in                                       grades Pre-K-6        nonparticipant         universal-free
                                                                                                                                  Central Falls, RI,                               (n=not reported)                             SBP school
                                                                                                                                  matched with
                                                                                                                                  schools in
                                                                                                                                  Providence, RI
                                                                                                                                  (1994)
                                                                                         Meyers et al.       Attendance,          16 schools in         School records and         Children in           Participant vs.        Ate SBP on 3 of 5         Multivariate regression
                                                                                                5
                                                                                         (1989)              tardiness,           Lawrence, MA          standardized test          grades 3-6            nonparticipant         days during 1
Economic Research Service/USDA




                                                                                                             academic             (1985-87)             scores                     (n=1,023)                                    selected week
                                                                                                             achievement                                                                                                        during school year
                                                                                           1
                                                                                             The study also examined impacts of BMI and food security and found no effects.
                                                                                           2
                                                                                             The study focused on students in grades 2-6. For sampling/matching purposes, schools with different grade configurations (e.g., K-2 and 3-5) were considered as one school unit. There
                                                                                         were a total of 73 treatment schools and 70 control schools.
                                                                                           3
                                                                                             The study’s main analysis compared outcomes for the entire treatment group with outcomes from the entire control group. Findings discussed in this report, however, are from a separate
                                                                                         analysis that estimated impacts based on students’ actual participation in universal-free breakfast. Impacts on short-term outcomes were estimated on the basis of participation on the day of
                                                                                         measurement and impacts on longer term outcomes were estimated on the basis of cumulative participation over the year.
                                                                                           4
                                                                                             For school-recorded data (maximum sample). Sample sizes varied for interview data (n=85) and teacher ratings (n=76).
                                                                                           5
                                                                                             The Meyers et al. study (1989) was not a study of universal-free breakfast. The study compared outcomes in schools that did and did not implement the SBP.
                               Nutrition Services Incentive Program
                          (formerly the Nutrition Program for the Elderly

              Note: This research actually focused on the Elderly Nutrition Program (ENP), which is
              sponsored by the U.S. Department of Health and Human Services. USDA’s Nutrition
              Program for the Elderly (NPE), now known as the Nutrition Services Incentive
              Program, provided supplemental commodities to ENP delivery sites, based on a
              per meal reimbursement rate.




Economic Research Service/USDA    Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4   103
104

                                                                                         Appendix table 14—Studies that examined the impact of the Elderly Nutrition Program on nutrition and health outcomes
                                                                                                                                                   Data collection        Population                             Measure of
                                                                                                                                           1
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                         Study                Outcome(s)      Data sources            method            (sample size)        Design              participation            Analysis method
                                                                                         Group I: National evaluations
                                                                                         Ponza et al.     Dietary intake   Random sample        24-hour dietary        ENP-eligible     Participant vs.      Received ENP meal       Multivariate regression;
                                                                                         (1996)           and social       of ENP partici-      recall and in-person   elderly          nonparticipant       on dietary recall day   attempted to control for
                                                                                         (National        contacts         pants (both          interview              (n=2,699)                             (did not necessarily    selection bias
                                                                                         Evaluation of                     congregate and                                                                    consume it)
                                                                                         the ENP—                          home-delivered)
                                                                                         1993-95)                          and random sam-
                                                                                                                           ple of nonpartici-
                                                                                                                           pants selected
                                                                                                                           from HCFA Medi-
                                                                                                                           care beneficiary
                                                                                                                           file (1993-95)
                                                                                         Kirschner and    Dietary intake   Participants in 70   24-hour dietary        ENP-eligible     Participant vs.      Ate ENP meal on         Chi-square tests
                                                                                         Associates       and              randomly             recall and isolation   elderly          nonparticipant       dietary recall day
                                                                                         and Opinion      socialization    selected ENP         index                  (n=3,411)        and compari-
                                                                                         Research                          sites (both                                                  sons to Wave I
                                                                                         Corporation -                     congregate and                                               participants still
                                                                                         Wave II (1983)                    home-delivered),                                             enrolled in
                                                                                                                           random sample                                                congregate sites
                                                                                                                           of participants’
                                                                                                                           neighbors, and
                                                                                                                           former partici-
                                                                                                                           pants (1976-77)
                                                                                         Kirschner and    Dietary intake   Participants in 91   24-hour dietary        ENP-eligible     Participant vs.      Ate ENP meal on         No statistical tests
                                                                                         Associates       and              randomly sel-        recall and isolation   elderly          nonparticipant       dietary recall day      conducted
                                                                                         and Opinion      socialization    ected ENP sites      index                  (n=4,563)
                                                                                         Research                          (congregate only)
                                                                                         Corporation -                     and random sam-
                                                                                         Wave I (1979)                     ple of partici-
                                                                                                                           pants’ neighbors
                                                                                                                           (1982)
Economic Research Service/USDA




                                                                                         Group IIA: State and local studies of congregate meals
                                                                                         Gilbride et al.  Dietary intake   Residents in HUD 2 24-hour dietary          ENP-eligible     Participant vs.      Currently receiving     No statistical tests
                                                                                         (1998)           and nutritional  elderly housing      recalls, food          elderly (n=40)   nonparticipant       ENP meals               conducted
                                                                                                          risk             facilities in metro- frequency, 5-day
                                                                                                                           politan New York     food records, and
                                                                                                                           City; nonpartici-    level-one screen
                                                                                                                           pants from facili-   from Nutrition
                                                                                                                           ties that did not    Screening Initiative
                                                                                                                           have ENP (dates      checklist
                                                                                                                           not reported
                                                                                          See notes at end of table.                                                                                                                                 Continued—
Economic Research Service/USDA

                                                                                         Appendix table 14—Studies that examined the impact of the Elderly Nutrition Program on nutrition and health outcomes—Continued
                                                                                                                                                     Data collection         Population                            Measure of
                                                                                                                                             1
                                                                                         Study                Outcome(s)       Data sources             method             (sample size)          Design           participation           Analysis method
                                                                                         Neyman et al.      Dietary intake,   Participants and     3-day food record,     ENP-eligible       Participant vs.   Ate ENP meal on        Multifactorial analysis of
                                                                                         (1996)             weight status,    nonparticipants      venous blood           elderly (n=135)    nonparticipant    at least 1 food        variance
                                                                                                            nutritional       at 9 ENP sites in    sample, height and                                          record day
                                                                                                            biochemsitries    2 northern           weight
                                                                                                                              California
                                                                                                                              counties (dates
                                                                                                                              not reported)
                                                                                         Czajka-Narins      Dietary intake,   Participants in 6    1-day food record,     ENP-eligible       Participant vs.   Regular partici-       Chi-square tests and
                                                                                         et al. (1987)      weight status,    ENP sites in         24-hour recall, food   elderly, over 75   nonparticipant    pation: Ate at ENP     analysis of variance
                                                                                                            and nutritional   Missouri;            frequency, venous      years old                            meal site 2-5 times
                                                                                                            biochemistries    nonparticipants      blood sample,          (n=185)                              per week
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                              from senior          height, weight, and                                         Irregular partici-
                                                                                                                              center that did      tricep skinfolds                                            pation: Ate at ENP
                                                                                                                              not serve meals                                                                  site less than twice
                                                                                                                              (dates not                                                                       per week, but at
                                                                                                                              reported)                                                                        least once per week
                                                                                                                                                                                                               during last 4 months
                                                                                         LeClerc and        Dietary intake    Participants in 1    3-day food records     ENP-eligible,      Participant vs.   Ate ENP meal 3-5       Bivariate t-tests and
                                                                                         Thornbury                            ENP site in                                 low-income         nonparticipant    times per week         analysis of variance
                                                                                         (1983)                               central Maine;                              elderly (n=53)
                                                                                                                              nonparticipants
                                                                                                                              from federally-
                                                                                                                              subsidized
                                                                                                                              housing units in
                                                                                                                              same area (dates
                                                                                                                              not reported)
                                                                                         Nordstrom et       Iron intake and   Participants in 6    1-day food record      ENP-eligible       Participant vs.   Ate ENP meal on        Analysis of variance
                                                                                         al. (1982)         iron status       ENP sites in         and venous blood       elderly (n=320)    nonparticipant    food record day
                                                                                                                              Missouri;            sample
                                                                                                                              nonparticipants
                                                                                                                              from senior center
                                                                                                                              that did not serve
                                                                                                                              meals (1975)
                                                                                          See notes at end of table.                                                                                                                                  Continued—
105
106

                                                                                         Appendix table 14—Studies that examined the impact of the Elderly Nutrition Program on nutrition and health outcomes—Continued
                                                                                                                                                    Data collection         Population                            Measure of
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                             1
                                                                                         Study                Outcome(s)       Data sources            method             (sample size)          Design           participation          Analysis method
                                                                                         Kohrs et al.       Dietary intake,   Participants in 6   1-day food record,     ENP-eligible       Participant vs.   Regular partici-       Chi-square tests and
                                                                                         (1980)             weight status,    ENP sites in        24-hour recall, food   elderly (n=547)    nonparticipant    pation: Ate at ENP     analysis of variance
                                                                                                            and nutritional   Missouri;           frequency, venous                                           meal site 2-5 times
                                                                                                            biochemistries    nonparticipants     blood sample,                                               per week
                                                                                                                              from senior         height, weight, and                                         Irregular partici-
                                                                                                                              center that did     tricep skinfolds                                            pation: Ate at ENP
                                                                                                                              not serve meals                                                                 site less than twice
                                                                                                                              (1975)                                                                          per week, but at
                                                                                                                                                                                                              least once per week
                                                                                                                                                                                                              during last 4 months
                                                                                         Singleton et al.   Dietary intake Participants in 7  24-hour dietary            ENP-eligible,      Participant vs.   Ate ENP meal on        Analysis of variance
                                                                                         (1980)                            ENP sites in       recall                     low-income         nonparticipant    dietary recall day
                                                                                                                           southern                                      elderly females
                                                                                                                           Louisiana;                                    (n=97)
                                                                                                                           nonparticipants
                                                                                                                           from 2 senior
                                                                                                                           centers that did
                                                                                                                           not serve meals
                                                                                                                           (dates not
                                                                                                                           reported)
                                                                                         Kohrs et al.     Dietary intake   Participants in 6  1-day food record          ENP-eligible       Participant vs.   Ate ENP meal on        Analysis of variance
                                                                                         (1978)                            ENP sites in                                  elderly (n=466)    nonparticipant    food record day
                                                                                                                           Missouri;
                                                                                                                           nonparticipants
                                                                                                                           from senior
                                                                                                                           center that did
                                                                                                                           not serve meals
                                                                                                                           (1973)
                                                                                         Group IIB: State and local studies of home-delivered meals
                                                                                         Edwards et al.   Food security,   Random sample      In-person interview        ENP-eligible,      Participant vs.   Currently receiving    Multivariate regression
                                                                                         (1998)           diet diversity,  of diabetic recip- and mail survey of         homebound          nonparticipant    ENP meals at least
Economic Research Service/USDA




                                                                                                          and diabetic     ients of home-     respondents’               diabetic elderly                     2 times per week
                                                                                                          control          delivered meals    physicians                 (n=154)
                                                                                                                           in New York
                                                                                                                           State and random
                                                                                                                           sample of non-
                                                                                                                           participants from
                                                                                                                           a waiting list
                                                                                                                           (1986-87)
                                                                                          See notes at end of table.                                                                                                                               Continued—
Economic Research Service/USDA

                                                                                         Appendix table 14—Studies that examined the impact of the Elderly Nutrition Program on nutrition and health outcomes—Continued
                                                                                                                                                            Data collection       Population                           Measure of
                                                                                                                                                    1
                                                                                         Study                    Outcome(s)           Data sources            method           (sample size)         Design           participation          Analysis method
                                                                                         Ho-Sang                Dietary intake       Recipients of        24-hour dietary      ENP-eligible,     Participant vs.   Currently receiving   Bivariate t-tests and
                                                                                         (1989)                 and weight           home-delivered       recall, height,      homebound         nonparticipant    ENP meals             multivariate regression
                                                                                                                status               meals in New         weight, and tricep   elderly (n=448)
                                                                                                                                     York State;          skinfolds
                                                                                                                                     nonparticipants
                                                                                                                                     from waiting lists
                                                                                                                                     for other
                                                                                                                                     programs (dates
                                                                                                                                     not reported)
                                                                                         Steele and             Dietary intake       Recipients of        24-hour dietary      ENP-eligible,     Participant vs.   Currently receiving   Bivariate t-tests
                                                                                         Bryan (1986)                                home-delivered       recall and diet      homebound         nonparticipant    1 ENP meal per
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                     meals from 1 site    history              elderly (n=54)                      day, 5 days per
                                                                                                                                     in North Carolina;                                                            week
                                                                                                                                     nonparticipants
                                                                                                                                     from a waiting
                                                                                                                                     list (1982-83)
                                                                                          1
                                                                                              All studies were primary data collection efforts.
107
                           Nutrition Assistance Program in Puerto Rico,
                           American Samoa, and the Northern Marianas




Economic Research Service/USDA   Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4   109
                                                                                         Appendix table 15—Studies that examined the impact of the Nutrition Assistance Program in Puerto Rico on household food expenditures
110


                                                                                         and/or nutrient availability
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                                    Population                              Measure of
                                                                                                                                                      1
                                                                                         Study                      Outcome(s)              Data source           (sample size)           Design            participation          Analysis method

                                                                                         Bishop al. (1996)      Household nutrient     1977 Puerto Rico        Participant and       Pre-cashout       Participation dummy    Stochastic dominance
                                                                                                                availability           supplement to the       income-eligible       compared with
                                                                                                                                       NFCS and 1984 Puerto    nonparticipant        cashout (1977
                                                                                                                                       Rico HFCS               households using      vs. 1984)
                                                                                                                                                               1977 eligibility
                                                                                                                                                               criteria (n= 3,995)
                                                                                         Hama (1993)            Household food         1984 Puerto Rico HFCS   Participant and       Participant vs.   Participation dummy    Multivariate regression
                                                                                                                expenditures                                   nonparticipant        nonparticipant
                                                                                                                                                               (including
                                                                                                                Household nutrient
                                                                                                                                                               ineligible)
                                                                                                                availability
                                                                                                                                                               households
                                                                                                                                                               (n=1,559)
                                                                                         Beebout et al.         Household food         1977 Puerto Rico        Participant and       Pre-cashout       Group membership       Multivariate regression,
                                                                                         (1985)                 expenditures           supplement to the       income-eligible       compared with     dummy, participation   with 2-equation selection-
                                                                                                                                       NFCS and 1984 Puerto    nonparticipant        cashout (1977     dummy, and benefit     bias models
                                                                                                                Household nutrient
                                                                                                                                       Rico HFCS               households using      vs. 1984)         amount
                                                                                                                availability
                                                                                                                                                               1977 eligibility
                                                                                                                                                               criteria (n= 3,995)
                                                                                          1
                                                                                              Data sources:
                                                                                               NFCS = Nationwide Food Consumption Survey.
                                                                                               HFCS = Household Food Consumption Survey.
Economic Research Service/USDA
                                 Commodity Supplemental Food Program




Economic Research Service/USDA      Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4   111
                                                                                         Appendix table 16—Studies that examined the impact of the Commodity Supplemental Food Program on nutrition and health outcomes of
112


                                                                                         low-income pregnant women and young children
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                                              Population                                     Measure of
                                                                                         Study                        Outcome(s)                  Data source               (sample size)              Design                participation               Analysis method

                                                                                         Mahony-Monrad            Women:                   2 CSFP sites in               Matched pairs of         Participant vs.      Participation dummy:        t-tests, analysis of
                                                                                         et al. (1982)            hemoglobin,              Memphis and 1 in              pregnant women           nonparticipant       Received food from          covariance, correlations
                                                                                                                  hematocrit,              Detroit (CSFP                 (n=421 pairs) and                             CSFP during study
                                                                                                                  pregnancy weight         participants) and area        children (n=236                               period
                                                                                                                                                                                1
                                                                                                                  gain, birthweight,       hospital/health               pairs)
                                                                                                                                                                                                                       Dose-response:
                                                                                                                  gestational age,         department clinics
                                                                                                                                                                                                                       Number of pickups,
                                                                                                                  APGAR score,             (nonparticipants)
                                                                                                                                                                                                                       number of prenatal
                                                                                                                  length of newborn        (1978-80)
                                                                                                                                                                                                                       care visits, and
                                                                                                                  hospital stay
                                                                                                                                                                                                                       percentage of
                                                                                                                  Children:                                                                                            recommended prenatal
                                                                                                                  hemoglobin,                                                                                          visits
                                                                                                                  hematocrit,
                                                                                                                  height, weight,
                                                                                                                  immunization status
                                                                                          1
                                                                                              Women were matched on age, race, number of previous pregnancies, smoking status, marital status, and prepregnancy weight. Children were matched on gender, race, and birthweight.
Economic Research Service/USDA
                                 WIC Farmers’ Market Nutrition Program




Economic Research Service/USDA      Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4   113
                                                                                         Appendix table 17—Studies that examined the impact of the WIC Farmers’ Market Nutrition Program on self-reported
114



                                                                                         fruit and vegetable consumption
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                                Population                               Measure of
                                                                                         Study                Outcome(s)              Data source             (sample size)           Design             participation         Analysis method

                                                                                         Anliker (1992)   Self-reported fruit   Randomly selected WIC      FMNP participants     Participants vs.   Received coupons      Analysis of covariance
                                                                                                          and vegetable         participants in 6 sites    (n=172)               nonparticipants,
                                                                                                          consumption           that participated in       Nonparticipants       before and after
                                                                                                                                FMNP and 3 sites that      (n=44)
                                                                                                                                did not (1989)
                                                                                         Galfond (1991)   Self-reported fruit   Randomly selected WIC      FMNP coupon           Participant vs.    Received coupons in   Bivariate t-tests
                                                                                                          and vegetable         participants in 6 States   recipient (n=1,503)   nonparticipant     current growing
                                                                                                          consumption           (1990)                     FMNP nonrecipients                       season
                                                                                                                                                           (n=1,126)
                                                                                                                                                           Recipients in prior
                                                                                                                                                           but not current
                                                                                                                                                           season (n=96)
Economic Research Service/USDA
                                         Special Milk Program




Economic Research Service/USDA   Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4   115
                                                                                         Appendix table 18—Studies that examined the impact of the Special Milk Program on children’s milk consumption
116



                                                                                                                                                                 Population                              Measure of
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                         Study                 Outcome(s)             Data source              (sample size)           Design            participation         Analysis method

                                                                                         Wellisch et al.   Dietary intake       Nationally representative   Children in grades    Participant vs.   Participation dummy   Multivariate regression
                                                                                         (1983)                                 sample of 90 school         1-12 (n=6,566)        nonparticipant
                                                                                                                                districts and 276 schools
                                                                                                                                across the country
                                                                                                                                (1980-81)


                                                                                         Robinson (1975)   Self-reported milk   Nationally representative   School-age            Participant vs.   Participation dummy   Comparison of means and
                                                                                                           consumption          sample of 768 schools       children (n=20,000)   nonparticipant                          proportions (no statistical
                                                                                                                                (1975)                                                                                    tests reported)
Economic Research Service/USDA
                                    Team Nutrition Initiative and
                             Nutrition Education and Training Program




Economic Research Service/USDA   Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4   117
                                                                                         Appendix table 19—Studies that examined the impact of the Team Nutrition Initiative or the Nutrition Education and Training Program
118



                                                                                         on school-age children
Effects of Food Assistance and Nutrition Programs on Nutrition and Health / FANRR-19-4




                                                                                                                                                                      Population                               Measure of
                                                                                         Study                   Outcome(s)                Data source              (sample size)           Design             participation         Analysis method

                                                                                         USDA, 1998          Nutrition-related       4 purposefully selected     Children in 4th       Participant vs.    Participation dummy   Multivariate regression
                                                                                                             knowledge,              school districts; 24        grade (n=144)         nonparticipant,
                                                                                                             attitudes, self-        schools (1996)                                    before and after
                                                                                                             reported and
                                                                                                             observed eating
                                                                                                             behaviors
                                                                                         Shannon and         Nutrition-related       12 school districts and     Children in grades    Participants,      Participation dummy   Analysis of covariance
                                                                                                                                                                                  rd
                                                                                         Chen (1988)         knowledge,              35 schools across           3-5 (n=1,707 3        before and after
                                                                                                             attitudes, and self-    Pennsylvania                graders in initial    (sequential
                                                                                                             reported eating         (dates not reported)        sample)               nutrition
                                                                                                             behaviors                                                                 education
                                                                                                                                                                                       program that
                                                                                                                                                                                       spanned 3
                                                                                                                                                                                       school years)
                                                                                         Banta et al,        Plate waste,            48 schools across           Plate waste:          Participant vs.    Participation dummy   Not described
                                                                                         (1984)              nutrition-related       Tennessee (dates not        Children in grades    nonparticipant,
                                                                                                             knowledge,              reported)                   K-6 (n=1,462)         before and after
                                                                                                             attitudes, and self-                                All other outcomes:
                                                                                                             reported eating                                     Children in grades
                                                                                                             behaviors                                           K-12 (n=862)
                                                                                         Gillespie (1984)    Nutrition-related       6 elementary schools in     Children in grades    Participant vs.    Participation dummy   Bivariate t-tests, chi-square
                                                                                                             knowledge,              central New York State      K-6 (n=1,157)         nonparticipant,                          tests, and Wilcoxon
                                                                                                             attitudes, and          (1979-80)                                         before and after                         signed ranks tests
                                                                                                             snacking behaviors
                                                                                         St. Pierre and      Nutrition-related       7 school districts across   Children in grades    Participant vs.    Participation dummy   Analysis of covariance,
                                                                                         Glotzer (1981)      knowledge,              Georgia (1980)              1-8 (n=1,400)         nonparticipant                           using both children and
                                                                                                             attitudes,                                                                                                         classrooms as the unit of
                                                                                                             preferences, and                                                                                                   analysis
Economic Research Service/USDA




                                                                                                             self-reported eating
                                                                                                             behaviors
                                                                                         St. Pierre et al.   Nutrition-related       20 schools across           Children in grades    Randomized         Participation dummy   Analysis of covariance,
                                                                                         (1981)              knowledge, attitudes,   Nebraska (1980)             1-6 (n=2,351)         experiment with                          using both children and
                                                                                                             preferences, self-                                                        random                                   classrooms as the unit of
                                                                                                             reported eating                                                           assignment at                            analysis
                                                                                                             behaviors, and plate                                                      the school level
                                                                                                             waste